Provider Demographics
NPI:1356323679
Name:TALOSIG, SOCORRO AGGABAO (PEDIATRICS)
Entity Type:Individual
Prefix:DR
First Name:SOCORRO
Middle Name:AGGABAO
Last Name:TALOSIG
Suffix:
Gender:F
Credentials:PEDIATRICS
Other - Prefix:DR
Other - First Name:SOCORRO
Other - Middle Name:AGGABAO
Other - Last Name:TALOSIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PEDIATRICS
Mailing Address - Street 1:402 S WINFREE ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-2942
Mailing Address - Country:US
Mailing Address - Phone:936-258-2624
Mailing Address - Fax:936-258-2488
Practice Address - Street 1:402 S WINFREE ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-2942
Practice Address - Country:US
Practice Address - Phone:936-258-2624
Practice Address - Fax:936-258-2488
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6129208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00LL39Medicare PIN
TXB26851Medicare UPIN