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General NPI Number Information
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NPI Number | 1386439933
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Entity Type | Organization
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Legal Business Name | WELLMED HEALTH CENTER LLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1530 SW 119TH ST UNIT 104
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-4938
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Country | US
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Telephone | 405-796-8367
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Fax | 405-716-4808
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Provider Business Mailing Address
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Address Line | 10108 NE 145TH ST
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City | JONES
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State | OK
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Zip | 73049-4948
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Country | US
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Telephone | 312-863-9121
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Fax | 405-716-4808
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Authorized Official
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Title or Position | CEO
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Name | RAJANI K CHILAKAPATI
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Credential | MD
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Telephone | 312-863-9121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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