Provider Demographics
NPI:1508258716
Name:SOTO, ANGELICA (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N HIGHWAY 175 STE 7
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-2361
Mailing Address - Country:US
Mailing Address - Phone:469-333-5151
Mailing Address - Fax:469-333-5156
Practice Address - Street 1:1110 N HIGHWAY 175 STE 7
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-2361
Practice Address - Country:US
Practice Address - Phone:469-333-5151
Practice Address - Fax:469-333-5156
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX738756363LF0000X
TXAP127568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP127568OtherTEXAS STATE BOARD OF NURSING