Healthcare Provider Details
I. General information
NPI: 1164452876
Provider Name (Legal Business Name): SONAL DHOLAKIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9090 KATY FWY STE 200
HOUSTON TX
77024-1696
US
IV. Provider business mailing address
9090 KATY FWY STE 200
HOUSTON TX
77024-1696
US
V. Phone/Fax
- Phone: 832-522-8720
- Fax: 713-468-3691
- Phone: 832-522-8720
- Fax: 713-468-3691
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | K65653 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: