Provider Demographics
NPI:1134539729
Name:PETROS, VINCENT SAMI (DO)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:SAMI
Last Name:PETROS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3101 W TECUMSEH RD
Mailing Address - Street 2:STE 101
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1816
Mailing Address - Country:US
Mailing Address - Phone:405-271-5428
Mailing Address - Fax:
Practice Address - Street 1:800 STANTON L YOUNG BLVD # WP1345
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5018
Practice Address - Country:US
Practice Address - Phone:405-271-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR2198207RG0100X
OK6473207RG0100X
TXBP10050269207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine