Provider Demographics
NPI:1992707673
Name:ROMERO, FREDDY (DC)
Entity type:Individual
Prefix:
First Name:FREDDY
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE BLDG A
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1241
Mailing Address - Country:US
Mailing Address - Phone:956-668-7246
Mailing Address - Fax:956-668-7247
Practice Address - Street 1:110 E SAVANNAH AVE BLDG A
Practice Address - Street 2:SUITE 201
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-668-7246
Practice Address - Fax:956-668-7247
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2009-09-30
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
TNDC9290TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U0900OtherBCBS
TX8L9913Medicare PIN
TXV03296Medicare UPIN