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NPI Code Detail

MEDICARE: DR. VICKI VRANA POPEJOY M.D.

MEDICARE: DR. VICKI VRANA POPEJOY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianM1295TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11751331-02OTHERTXCSHCN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38S1849OTHERTXBLUE SHIELD

General Provider Information

NPI Number : 1588625990
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICKI VRANA POPEJOY M.D.
Provider Business Mailing Address
First Line : PO BOX 848476
Second Line :
City : DALLAS
State : TX
Zip : 75284-8476
Country : US
Telephone Number : 254-202-4655
Fax Number : 254-202-4697
Provider Business Practice Location Address
First Line : 120 HILLCREST MEDICAL BLVD STE 100
Second Line :
City : WACO
State : TX
Zip : 76712-8949
Country : US
Telephone Number : 254-202-6100
Fax Number : 254-202-6195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 01/05/2021

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