Basic Information
Provider Information
NPI: 1689664732
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICH
FirstName: SONIA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: R.N.F.A.,O.P.A.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7401 S. MAIN
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber: 7137992300
FaxNumber: 7137919395
Practice Location
Address1: 7401 S. MAIN
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber: 7137992300
FaxNumber: 7137919395
Other Information
ProviderEnumerationDate: 10/28/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WX0800XOP0000781TXY Nursing Service ProvidersRegistered NurseOrthopedic

No ID Information.


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