Provider Demographics
NPI:1043400757
Name:SOSA, SAMETA FAIRCHILD (MD)
Entity Type:Individual
Prefix:
First Name:SAMETA
Middle Name:FAIRCHILD
Last Name:SOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMETA
Other - Middle Name:SHRAUNER
Other - Last Name:FAIRCHILD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1017 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-3501
Mailing Address - Country:US
Mailing Address - Phone:830-261-0886
Mailing Address - Fax:
Practice Address - Street 1:124 ROYAL LN
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4838
Practice Address - Country:US
Practice Address - Phone:830-278-6691
Practice Address - Fax:830-278-7533
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007016408207P00000X
TXN9962207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine