Provider Demographics
NPI:1841788197
Name:ROPER, ANTONIO GARCIA
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:GARCIA
Last Name:ROPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 S SHIELDS BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73129-2856
Mailing Address - Country:US
Mailing Address - Phone:405-679-1421
Mailing Address - Fax:
Practice Address - Street 1:3916 S SHIELDS BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-2856
Practice Address - Country:US
Practice Address - Phone:405-679-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist