Provider Demographics
NPI:1720715790
Name:STANTON, SOPHIA LOREN
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LOREN
Last Name:STANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 CARSON DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1716
Mailing Address - Country:US
Mailing Address - Phone:469-247-2757
Mailing Address - Fax:
Practice Address - Street 1:1105 CARSON DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1716
Practice Address - Country:US
Practice Address - Phone:469-247-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist