1265623862 NPI number — JORGE SOSA DDS

Table of content: JORGE SOSA DDS (NPI 1265623862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265623862 NPI number — JORGE SOSA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOSA
Provider First Name:
JORGE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265623862
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 961629
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79996
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-591-1709
Provider Business Mailing Address Fax Number:
915-591-1709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE AMERICAS #491
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUAREZ
Provider Business Practice Location Address State Name:
CHIH
Provider Business Practice Location Address Postal Code:
32310
Provider Business Practice Location Address Country Code:
MS
Provider Business Practice Location Address Telephone Number:
01152656111199
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  3589455 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com