Provider Demographics
NPI:1275354086
Name:CHOUDHARY, SOHAIL ASHRAF
Entity type:Individual
Prefix:
First Name:SOHAIL
Middle Name:ASHRAF
Last Name:CHOUDHARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 FOREST HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3501
Mailing Address - Country:US
Mailing Address - Phone:917-361-9400
Mailing Address - Fax:
Practice Address - Street 1:1037 FOREST HAVEN CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3501
Practice Address - Country:US
Practice Address - Phone:917-361-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43167743172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty