Provider Demographics
NPI:1013173780
Name:BOINDALA, NAVEENA SESIKERAN (MD)
Entity Type:Individual
Prefix:
First Name:NAVEENA
Middle Name:SESIKERAN
Last Name:BOINDALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-427-2441
Mailing Address - Fax:405-427-4741
Practice Address - Street 1:2601 SPENCER RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3649
Practice Address - Country:US
Practice Address - Phone:405-427-2441
Practice Address - Fax:405-427-4741
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK264892084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry