Provider Demographics
NPI:1205076213
Name:O.V.S., P.L.L.C.
Entity type:Organization
Organization Name:O.V.S., P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAUNDRA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SPRUIELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-947-8346
Mailing Address - Street 1:5030 N MAY AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6010
Mailing Address - Country:US
Mailing Address - Phone:405-947-8346
Mailing Address - Fax:405-751-8960
Practice Address - Street 1:13820 WIRELESS WAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-2501
Practice Address - Country:US
Practice Address - Phone:405-947-8346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2831207Q00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5693Medicare PIN