1659927176 NPI number — ALEXANDRA MARIE ROMANELLI DPT, PT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659927176 NPI number — ALEXANDRA MARIE ROMANELLI DPT, PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMANELLI
Provider First Name:
ALEXANDRA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT, PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659927176
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2051 WITTINGTON PL APT 3185
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMERS BRANCH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75234-1924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-680-0185
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3705 LAKEVIEW PKWY STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROWLETT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75088-4178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-443-0458
Provider Business Practice Location Address Fax Number:
469-573-6918
Provider Enumeration Date:
08/12/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1320196 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com