Provider Demographics
NPI:1275625212
Name:J RAUL SOTO MD PA
Entity Type:Organization
Organization Name:J RAUL SOTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:CMC
Authorized Official - Phone:713-580-0234
Mailing Address - Street 1:7789 SOUTHWEST FWY, STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-580-0234
Mailing Address - Fax:713-580-0259
Practice Address - Street 1:7789 SOUTHWEST FWY, STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1833
Practice Address - Country:US
Practice Address - Phone:713-580-0234
Practice Address - Fax:713-580-0259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159754401Medicaid
TX0078JAOtherBCBS
TX2804832OtherAETNA
TX10016562OtherAMERIGROUP
TX060070473OtherMEDCARE RAILROAD
TX10016562OtherAMERIGROUP
TX00422TMedicare ID - Type Unspecified