Basic Information
| Provider Information | |||||||||
| NPI: | 1174812945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMAN | ||||||||
| FirstName: | PATRICIO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2660 SW 3RD ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666062442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852708880 | ||||||||
| FaxNumber: | 7852708881 | ||||||||
| Practice Location | |||||||||
| Address1: | 2660 SW 3RD ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852708880 | ||||||||
| FaxNumber: | 7852708881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2011 | ||||||||
| LastUpdateDate: | 03/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | PENDING | KS | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.