Provider Demographics
NPI:1508429333
Name:MOMIN, SOFI (DO)
Entity Type:Individual
Prefix:
First Name:SOFI
Middle Name:
Last Name:MOMIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 PINECROFT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3482
Mailing Address - Country:US
Mailing Address - Phone:713-897-7500
Mailing Address - Fax:281-325-4292
Practice Address - Street 1:9305 PINECROFT DR STE 101
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3482
Practice Address - Country:US
Practice Address - Phone:713-897-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine