Provider Demographics
NPI:1407048978
Name:VARDEY, SHEELA (MD)
Entity type:Individual
Prefix:DR
First Name:SHEELA
Middle Name:
Last Name:VARDEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12620 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2676
Mailing Address - Country:US
Mailing Address - Phone:918-493-2229
Mailing Address - Fax:918-493-7819
Practice Address - Street 1:12620 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-2676
Practice Address - Country:US
Practice Address - Phone:918-574-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27944208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1007471Medicaid
OK200305830AMedicaid
OKOKAAA2144Medicare PIN