Provider Demographics
NPI:1356531701
Name:MELVILLE, SONYA COOPER (MD)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:COOPER
Last Name:MELVILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 960046
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0046
Mailing Address - Country:US
Mailing Address - Phone:800-684-0094
Mailing Address - Fax:405-844-1794
Practice Address - Street 1:1600 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6913
Practice Address - Country:US
Practice Address - Phone:817-848-4000
Practice Address - Fax:817-848-4863
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2013-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP4204207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP011614583OtherRAILROAD MCARE
TXP011614583OtherRAILROAD MCARE