Provider Demographics
NPI:1255327789
Name:BAJAJ, SONIA (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:BAJAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6278
Mailing Address - Street 2:ATTN: HMA ADMINISTRATION
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0278
Mailing Address - Country:US
Mailing Address - Phone:817-568-4556
Mailing Address - Fax:817-568-5474
Practice Address - Street 1:795 E FM 1187 STE A
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4346
Practice Address - Country:US
Practice Address - Phone:817-293-9631
Practice Address - Fax:817-293-9681
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM7021207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM7021OtherTEXAS MEDICAL LICENSE
TX1255327789Medicaid
TXM7021OtherTEXAS MEDICAL LICENSE
TX191507601Medicaid