Provider Demographics
NPI:1487001756
Name:SOROKOLIT PODIATRY PLLC
Entity Type:Organization
Organization Name:SOROKOLIT PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROKOLIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-479-1996
Mailing Address - Street 1:908 9TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3904
Mailing Address - Country:US
Mailing Address - Phone:817-877-5781
Mailing Address - Fax:817-877-5782
Practice Address - Street 1:908 9TH AVE STE A
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3904
Practice Address - Country:US
Practice Address - Phone:817-877-5781
Practice Address - Fax:817-877-5782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty