Provider Demographics
NPI:1528189875
Name:HUNT, SOPHIE MONTMONY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SOPHIE
Middle Name:MONTMONY
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 W US HWY 290 SERVICE RD, BLDG. 2
Mailing Address - Street 2:STE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735
Mailing Address - Country:US
Mailing Address - Phone:512-387-1372
Mailing Address - Fax:855-571-5050
Practice Address - Street 1:5100 W US HWY 290 SERVICE RD, BLDG. 2
Practice Address - Street 2:STE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735
Practice Address - Country:US
Practice Address - Phone:512-387-1372
Practice Address - Fax:855-571-5050
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N808Medicare ID - Type Unspecified
TXP46747Medicare UPIN