Provider Demographics
NPI:1205812872
Name:NIEVES-SOSA, JOSE (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:NIEVES-SOSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W JEFFERSON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6329
Mailing Address - Country:US
Mailing Address - Phone:956-550-8733
Mailing Address - Fax:866-607-4011
Practice Address - Street 1:800 W JEFFERSON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6329
Practice Address - Country:US
Practice Address - Phone:956-550-8733
Practice Address - Fax:956-550-9299
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085787201Medicaid
TXE04110OtherGROUP UPIN
TXF94317OtherUPIN
TX137963808Medicaid
TX00U81ZMedicare UPIN
TXF94317OtherUPIN