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General NPI Number Information
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NPI Number | 1386983898
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Entity Type | Individual
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Provider Name | SONYTA SO PA
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 12950 DALLAS PKWY STE 100
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City | FRISCO
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State | TX
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Zip | 75033-4235
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Country | US
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Telephone | 972-377-8695
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Fax |
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Provider Business Mailing Address
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Address Line | 2344 GREENCREST BLVD
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City | ROCKWALL
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State | TX
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Zip | 75087-5513
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Country | US
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Telephone | 469-689-0936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06399
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License Number State | TX
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