Healthcare Provider Details

I. General information

NPI: 1205076213
Provider Name (Legal Business Name): O.V.S., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13820 WIRELESS WAY
OKLAHOMA CITY OK
73134-2501
US

IV. Provider business mailing address

5030 N MAY AVE SUITE 116
OKLAHOMA CITY OK
73112-6010
US

V. Phone/Fax

Practice location:
  • Phone: 405-947-8346
  • Fax:
Mailing address:
  • Phone: 405-947-8346
  • Fax: 405-751-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2831
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number2831
License Number StateOK

VIII. Authorized Official

Name: DR. SAUNDRA SUE SPRUIELL
Title or Position: MANAGING MEMBER
Credential: D.O.
Phone: 405-947-8346