Provider Demographics
NPI:1386653897
Name:ANTONIO SOEGAARD-TORRES MD, PA
Entity Type:Organization
Organization Name:ANTONIO SOEGAARD-TORRES MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOEGAARD-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-751-5571
Mailing Address - Street 1:9870 GATEWAY BLVD N STE B1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-4414
Mailing Address - Country:US
Mailing Address - Phone:915-751-5571
Mailing Address - Fax:915-751-0951
Practice Address - Street 1:9870 GATEWAY BLVD N STE B1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4414
Practice Address - Country:US
Practice Address - Phone:915-751-5571
Practice Address - Fax:915-751-0951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9357207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ1755OtherNM MEXCIO ID NUMBER
NMZ1755OtherNM MEXCIO ID NUMBER
NMZ1755OtherNM MEXCIO ID NUMBER