Active NPI
Sophia Arusuaine Ederaine
- Dermatology Physician
- Houston, TX
National Provider Identifier
1962142950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- W5781
- Practice address
- 17756 Katy Fwy Ste G1
Houston, TX 77094-1380 - Phone
- (832) 772-3330
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | W5781 | TX | Primary |
Addresses
Primary practice location
17756 Katy Fwy Ste G1
Houston, TX 77094-1380
Mailing address
17756 Katy Fwy Ste G1
Houston, TX 77094-1380
Phone (832) 772-3330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Mayo Medical School, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12869 Gerrard St
Moreno Valley, CA 92553-1845
17756 Katy Fwy
Suite G1
Houston, TX 77094
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1962142950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17756 KATY FWY STE G1",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770941380",
"telephone_number": "832-772-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17756 KATY FWY STE G1",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770941380",
"telephone_number": "832-772-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDERAINE",
"first_name": "SOPHIA",
"middle_name": "ARUSUAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "W5781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.