Doctor Name: | JERRY ROMANS |
NPI Number: | 1700065125 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 5012 Trinity Landing Dr W Fort Worth, TX - 761323736 |
Business Phone Number: | 8177018642 |
Business Fax Number: | |
Mailing Address: | 5012 Trinity Landing Dr W, FORT WORTH |
State: | TX |
Postal Code: | 761323736 |
Phone Number: | 8177018642 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2007 |
NPI Last Update Date: | 11/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |