Healthcare Provider Details

I. General information

NPI: 1548710122
Provider Name (Legal Business Name): VIMALA SEKAR, M.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 NW 39TH ST
OKLAHOMA CITY OK
73112-8884
US

IV. Provider business mailing address

4113 OAKDALE FARM CIR
EDMOND OK
73013-7513
US

V. Phone/Fax

Practice location:
  • Phone: 405-415-2304
  • Fax:
Mailing address:
  • Phone: 405-415-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14311
License Number StateOK

VIII. Authorized Official

Name: VIMALA SEKAR
Title or Position: PRESIDENT
Credential: M.D
Phone: 405-415-2304