Provider Demographics
NPI:1467552992
Name:SOO, DAVID D (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:SOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:909 FROSTWOOD DR STE 1.10
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-5519
Mailing Address - Fax:
Practice Address - Street 1:3525 W HOLCOMBE BLVD FL 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1313
Practice Address - Country:US
Practice Address - Phone:713-814-2800
Practice Address - Fax:847-599-8897
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-072946207Q00000X
TXS3462207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44099Medicare UPIN