Provider Demographics
NPI:1851875512
Name:BIJI, SONY VELLAVOOR (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:SONY
Middle Name:VELLAVOOR
Last Name:BIJI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LAVAINE LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4229
Mailing Address - Country:US
Mailing Address - Phone:972-394-0487
Mailing Address - Fax:
Practice Address - Street 1:6020 W PARKER RD STE 330
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0005
Practice Address - Country:US
Practice Address - Phone:469-367-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX668514163WM0102X
TXAP139305363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn