Provider Demographics
NPI:1417058090
Name:KIOK, SOLEDAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLEDAD
Middle Name:
Last Name:KIOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SOLEDAD
Other - Middle Name:CHU
Other - Last Name:TE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:703 WINDERMERE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2645
Mailing Address - Country:US
Mailing Address - Phone:318-561-9907
Mailing Address - Fax:
Practice Address - Street 1:2495 SHREVEPORT HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:318-483-5055
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010400732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology