Provider Demographics
NPI:1588625990
Name:POPEJOY, VICKI VRANA (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:VRANA
Last Name:POPEJOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 848476
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8476
Mailing Address - Country:US
Mailing Address - Phone:254-202-4655
Mailing Address - Fax:254-202-4697
Practice Address - Street 1:120 HILLCREST MEDICAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8949
Practice Address - Country:US
Practice Address - Phone:254-202-6100
Practice Address - Fax:254-202-6195
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1295208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1751331-02OtherCSHCN
TX1751331-01Medicaid
TX8S1849OtherBLUE SHIELD