Organization Name: | ISAAC SOSA M.D. P.A. |
NPI Number: | 1114127347 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN ROSE CHAMPAGNE-MILLER (ADMINISTRATOR) |
Mailing Address: | 1195 Garner Field Rd Ste. 400 Uvalde |
State: | TX US |
Postal Code: | 788014822 |
Phone Number: | 8302786265 |
Fax Number: | 8302786286 |
NPI Enumeration Date: | 07/25/2007 |
NPI Last Update Date: | 10/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | H7829 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |