Provider Demographics
NPI:1063140358
Name:SONI, SHIVANGI
Entity type:Individual
Prefix:
First Name:SHIVANGI
Middle Name:
Last Name:SONI
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 1:1395 E ELDORADO PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5508
Mailing Address - Country:US
Mailing Address - Phone:469-200-5974
Mailing Address - Fax:
Practice Address - Street 1:1395 E ELDORADO PKWY STE 400
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5508
Practice Address - Country:US
Practice Address - Phone:469-200-5974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043474363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043473OtherTEXAS BOARD OF NURSING