Healthcare Provider Details

I. General information

NPI: 1407048978
Provider Name (Legal Business Name): SHEELA VARDEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12620 S MEMORIAL DR
BIXBY OK
74008-2676
US

IV. Provider business mailing address

12620 S MEMORIAL DR
BIXBY OK
74008-2676
US

V. Phone/Fax

Practice location:
  • Phone: 918-574-0150
  • Fax:
Mailing address:
  • Phone: 918-493-2229
  • Fax: 918-493-7819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27944
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: