Provider Demographics
NPI:1902193865
Name:CAERO ROMERO, ANDRES RODRIGO (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:RODRIGO
Last Name:CAERO ROMERO
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:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-0637
Mailing Address - Country:US
Mailing Address - Phone:580-223-8614
Mailing Address - Fax:580-223-2561
Practice Address - Street 1:2611 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2574
Practice Address - Country:US
Practice Address - Phone:580-223-8614
Practice Address - Fax:580-223-2561
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32863207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK32863OtherSTATE MEDICAL LICENSE