Provider Demographics
NPI:1437820271
Name:ARRAS, SOFIA CARRILLO
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:CARRILLO
Last Name:ARRAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 LOOKOUT RD APT 1526
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3509
Mailing Address - Country:US
Mailing Address - Phone:915-317-2246
Mailing Address - Fax:
Practice Address - Street 1:15400 LOOKOUT RD APT 1526
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3509
Practice Address - Country:US
Practice Address - Phone:915-317-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2021033533363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health