Healthcare Provider Details

I. General information

NPI: 1275547366
Provider Name (Legal Business Name): ROBERT LEE SILVER P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 SE 29TH ST
DEL CITY OK
73115-2639
US

IV. Provider business mailing address

3905 SE 29TH ST
DEL CITY OK
73115-2639
US

V. Phone/Fax

Practice location:
  • Phone: 405-670-5569
  • Fax: 405-670-5571
Mailing address:
  • Phone: 405-670-5569
  • Fax: 405-670-5571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP.T. 903
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: