Provider Demographics
NPI:1477585255
Name:SONIK, STACY MICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:MICHELLE
Last Name:SONIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WHIPPLE DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5339
Mailing Address - Country:US
Mailing Address - Phone:713-553-5163
Mailing Address - Fax:
Practice Address - Street 1:4710 BELLAIRE BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4526
Practice Address - Country:US
Practice Address - Phone:713-553-5163
Practice Address - Fax:713-664-9633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05278TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU70205Medicare UPIN
TX00488EMedicare ID - Type Unspecified