Provider Demographics
NPI:1043392889
Name:LOFTIS-DAYAL, SONYA F (MD)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:F
Last Name:LOFTIS-DAYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4095
Practice Address - Fax:682-885-7499
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2993207PP0204X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4617976OtherCIGNA PIN
TX2218193OtherUHC PIN
TX8H8783OtherBCBSTX IND PIN
TX2024417OtherFIRSTHEALTH PIN
TX7915410OtherAETNA PIN
TX00U87ZOtherBCBSTX GRP PIN
TX114849100OtherFIRSTCARE PIN
TX9222141OtherPHCS PIN
TX140442884Medicaid
TX150870710Medicaid
1750369203OtherGRP NPI NUMBER
TX137072808Medicaid
H59454Medicare UPIN
TX8G0096Medicare ID - Type UnspecifiedIND MEDICARE
TX00U87ZOtherBCBSTX GRP PIN