Individual
MRS. VIDYA REGE DRAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
927 S COUNTRY CLUB RD, EL RENO, OK 73036-4907
(405) 262-9900
(405) 262-9949
Mailing address
927 S COUNTRY CLUB RD, EL RENO, OK 73036-4907
(405) 262-9900
(405) 262-9949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OK11132
OK
207W00000X
Ophthalmology Physician
Primary
11132
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100021390B
—
OK
Enumeration date
08/02/2005
Last updated
05/03/2016
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