Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sophia Marin, PA

Individual provider Physician Assistant · NPI 1639809049

Sophia Marin, PA is a Physician Assistant in Grand Prairie, Texas. Qualified in 2022, 4 years ago. Practices with Legacy Urgent Care PA, a 158-clinician group. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2045 N Hwy 360 # 100B
Grand Prairie, TX 75050-1403
Phone: (972) 623-1111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA16755 (TX)

Record details

NPI number1639809049
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 16, 2022
Last updated in NPPESJune 18, 2025
Certification dateJune 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Legacy Urgent Care Pa — 158 clinicians
Accepts Medicare assignment Not indicated
Practice locations6 on file with Medicare

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