1821144981 NPI number — OSCAR SOTELO M.D.

Table of content: OSCAR SOTELO M.D. (NPI 1821144981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821144981 NPI number — OSCAR SOTELO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOTELO
Provider First Name:
OSCAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1821144981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7012 N 10TH ST
Provider Second Line Business Mailing Address:
STE 40
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-3397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-682-1591
Provider Business Mailing Address Fax Number:
956-682-1592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7012 N 10TH ST
Provider Second Line Business Practice Location Address:
STE 40
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78504-3397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-682-1591
Provider Business Practice Location Address Fax Number:
956-682-1592
Provider Enumeration Date:
01/25/2007

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: 174400000X , with the licence number:  D-5212 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: D5212 , 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)

  • Identifier: 1155491-03 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8CQ495 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 071900037 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1155491-04 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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