MEDICARE: SONYA MARLISE GOTCH FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1098117	TX

General Provider Information

NPI Number	:	1225744675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA MARLISE GOTCH FNP-C

Provider Business Mailing Address
First Line	:	4311 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5627
Country	:	US
Telephone Number	:	682-351-0205
Fax Number	:

Provider Business Practice Location Address
First Line	:	4311 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5627
Country	:	US
Telephone Number	:	817-652-3395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	03/26/2025

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