Provider Demographics
NPI:1073608295
Name:KRISTIANSEN, SONJA BOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:BOHN
Last Name:KRISTIANSEN
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 1:9055 KATY FWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1624
Mailing Address - Country:US
Mailing Address - Phone:713-862-6181
Mailing Address - Fax:713-464-2810
Practice Address - Street 1:9055 KATY FWY
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1624
Practice Address - Country:US
Practice Address - Phone:713-862-6181
Practice Address - Fax:713-464-2810
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7623174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0017EJOtherBCBS PROVIDER NUMBER
TX2242585OtherAETNA PROVIDER NUMBER
TX0017EJOtherBCBS PROVIDER NUMBER