Provider Demographics
NPI:1215040050
Name:SONE, DANIEL S (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:SONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 JUSTIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7193
Mailing Address - Country:US
Mailing Address - Phone:972-317-1110
Mailing Address - Fax:972-317-1556
Practice Address - Street 1:2012 JUSTIN RD STE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-7193
Practice Address - Country:US
Practice Address - Phone:972-317-1110
Practice Address - Fax:972-317-1556
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128949807Medicaid
TX128949806Medicaid
TXTXB109811Medicare PIN
TX86V283Medicare PIN
TXTXB109809Medicare PIN
TX8K7180Medicare PIN
TXG58650Medicare UPIN