Provider Demographics
NPI:1174556047
Name:ROMATOWSKI, ROBERT (PA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:ROMATOWSKI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 N BRYANT BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5257
Mailing Address - Country:US
Mailing Address - Phone:325-655-5125
Mailing Address - Fax:325-655-5340
Practice Address - Street 1:402 N BRYANT BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5257
Practice Address - Country:US
Practice Address - Phone:325-655-5125
Practice Address - Fax:325-655-5340
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01003363A00000X
OK4911363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR76882Medicare UPIN