Doctor Name: | DR. MICHAEL A ROMAN |
NPI Number: | 1255315693 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 24435 |
Business Practice Address: | 5410 Fredericksburg Rd Suite 302 San Antonio, TX - 782293554 |
Business Phone Number: | 2103421906 |
Business Fax Number: | 2103421909 |
Mailing Address: | 5410 Fredericksburg Rd, Suite 302 SAN ANTONIO |
State: | TX |
Postal Code: | 782293554 |
Phone Number: | 2103421906 |
Fax Number: | 2103421909 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 24435 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |