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General NPI Number Information
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NPI Number | 1639249139
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Entity Type | Individual
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Provider Name | PADMASHREE VELURY MD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 03/01/2013
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Provider Practice Location Address
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Address Line | 4411 W GORE BLVD SUITE B-3
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City | LAWTON
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State | OK
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Zip | 73505-5977
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Country | US
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Telephone | 580-536-5300
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Fax | 580-536-5304
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Provider Business Mailing Address
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Address Line | 5602 SW LEE BLVD
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City | LAWTON
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State | OK
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Zip | 73505-9635
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Country | US
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Telephone | 580-531-6408
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Fax | 580-531-4981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 24968
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License Number State | OK
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