Provider Demographics
NPI:1255435657
Name:ROYER, ANDREW P (OD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:P
Last Name:ROYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12990 MANCHESTER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1860
Mailing Address - Country:US
Mailing Address - Phone:314-966-5000
Mailing Address - Fax:314-909-6666
Practice Address - Street 1:12990 MANCHESTER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1860
Practice Address - Country:US
Practice Address - Phone:314-966-5000
Practice Address - Fax:314-909-6666
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COV07571Medicare UPIN