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General NPI Number Information
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NPI Number | 1750316410
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Entity Type | Individual
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Provider Name | SONYA L BROCK M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 1101 ALMA ST SUITE 104
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City | TOMBALL
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State | TX
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Zip | 77375-4554
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Country | US
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Telephone | 281-290-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 ALMA ST
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City | TOMBALL
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State | TX
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Zip | 77375-4554
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Country | US
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Telephone | 281-290-0018
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P5601
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License Number State | TX
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