Healthcare Provider Details

I. General information

NPI: 1568112993
Provider Name (Legal Business Name): SOPHIA DHANANI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 HOSPITAL PKWY STE 402
BEDFORD TX
76022-6932
US

IV. Provider business mailing address

1600 HOSPITAL PKWY
BEDFORD TX
76022-6913
US

V. Phone/Fax

Practice location:
  • Phone: 817-848-4110
  • Fax: 817-848-0023
Mailing address:
  • Phone: 817-848-2993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV9589
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: