Provider Demographics
NPI:1134217888
Name:SLOAN, SONYA MYLES (MD)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:MYLES
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:M
Other - Last Name:SLOAN, PLLC.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12680 WEST LAKE HOUSTON PKWY.
Mailing Address - Street 2:SUITE 510-150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044
Mailing Address - Country:US
Mailing Address - Phone:855-234-6393
Mailing Address - Fax:281-459-6565
Practice Address - Street 1:3330 MASONIC DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:800-328-3065
Practice Address - Fax:801-264-6463
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
LALA.202404MD207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09309390Medicaid
LA1365947Medicaid
MS09309390Medicaid