Provider Demographics
NPI:1821004193
Name:BHATIA, SONIA (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:BHATIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8107 SPRINGDALE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-2437
Mailing Address - Country:US
Mailing Address - Phone:512-651-8644
Mailing Address - Fax:512-651-8635
Practice Address - Street 1:8107 SPRINGDALE RD STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-2437
Practice Address - Country:US
Practice Address - Phone:512-651-8644
Practice Address - Fax:512-651-8635
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3161207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187007302Medicaid
TX187007304Medicaid
TX1I6024OtherMEDICARE
TX187007317Medicaid
TX187007301Medicaid
TX187007303Medicaid
TX187007304Medicaid
TXTXB155583Medicare PIN
TX187007301Medicaid