Provider Demographics
NPI:1164154589
Name:PATEL, SOPHIA LOREN (NP)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LOREN
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 ANDREWS HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-5132
Mailing Address - Country:US
Mailing Address - Phone:432-522-1234
Mailing Address - Fax:
Practice Address - Street 1:3403 ANDREWS HWY STE 300
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5132
Practice Address - Country:US
Practice Address - Phone:432-522-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2025-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276693363LF0000X
TX1203383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily