Provider Demographics
NPI:1508839093
Name:OBSEQUIO, ROMEO LAPUS (MD)
Entity Type:Individual
Prefix:
First Name:ROMEO
Middle Name:LAPUS
Last Name:OBSEQUIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:918-542-5551
Mailing Address - Fax:918-542-1555
Practice Address - Street 1:310 2ND AVE SW STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6708
Practice Address - Country:US
Practice Address - Phone:918-542-5551
Practice Address - Fax:918-542-1555
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100248490AMedicaid
OK200468380PMedicaid
OK110216566Medicare PIN
OK900522214Medicare PIN
OK299076YKW9Medicare PIN
OK100248490AMedicaid
OKCR1165Medicare PIN