Provider Demographics
NPI:1447250014
Name:SONI, PINA RISHIKESH (ANP)
Entity type:Individual
Prefix:
First Name:PINA
Middle Name:RISHIKESH
Last Name:SONI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:PINA
Other - Middle Name:
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 650866
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0866
Mailing Address - Country:US
Mailing Address - Phone:972-175-5000
Mailing Address - Fax:
Practice Address - Street 1:13737 NOEL ROAD
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-2004
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX685497363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178898603Medicaid
TX178898602Medicaid
TX178898601Medicaid
TX8N9843OtherBCBS
TXP00424852OtherRR MEDICARE
TX8G4168Medicare PIN
TXTXB102494Medicare PIN
TX8N9843OtherBCBS
TX8G5472Medicare PIN
TX8L12124Medicare PIN