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General NPI Number Information
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NPI Number | 1922498112
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Entity Type | Individual
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Provider Name | DR. STEVE GARCIA CISNEROS
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Gender | Male
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST # 116A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-456-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 333 NW 5TH ST APT 1607
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-3000
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Country | US
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Telephone | 312-799-9988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0005123
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0005123
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License Number State | CO
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