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General NPI Number Information
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NPI Number | 1851875512
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Entity Type | Individual
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Provider Name | SONY VELLAVOOR BIJI NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 6020 W PARKER RD STE 330
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City | PLANO
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State | TX
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Zip | 75093-0005
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Country | US
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Telephone | 469-367-0225
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Fax |
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Provider Business Mailing Address
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Address Line | 520 LAVAINE LN
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City | LEWISVILLE
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State | TX
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Zip | 75056-4229
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Country | US
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Telephone | 972-394-0487
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Fax |
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 668514
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP139305
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License Number State | TX
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