Provider Demographics
NPI:1639102338
Name:O'SHEA, OPHELIA VELASQUEZ (WHNP)
Entity Type:Individual
Prefix:MS
First Name:OPHELIA
Middle Name:VELASQUEZ
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 SWISS AVENUE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:214-820-8700
Mailing Address - Fax:214-818-8707
Practice Address - Street 1:4501 SWISS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-820-8700
Practice Address - Fax:214-818-8707
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643424363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172976605Medicaid
TX172976601Medicaid
TX172976602Medicaid
TX172976604Medicaid
TX172976603Medicaid
TX8Y0091OtherBCBS
TX8L27522Medicare PIN
TX8L27468Medicare PIN
TX8D5114Medicare PIN
TX172976601Medicaid
TX172976602Medicaid
TX172976604Medicaid
TX8Y0091OtherBCBS
TXP00862884Medicare PIN