Provider Demographics
NPI:1598212912
Name:BUTH, SOTHARY (CSFA)
Entity Type:Individual
Prefix:MS
First Name:SOTHARY
Middle Name:
Last Name:BUTH
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:MS
Other - First Name:SOTHARY
Other - Middle Name:
Other - Last Name:BUTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSFA , CST
Mailing Address - Street 1:3300 FALCON LANDING BLVD APT 7104
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7767
Mailing Address - Country:US
Mailing Address - Phone:281-704-0932
Mailing Address - Fax:
Practice Address - Street 1:3300 FALCON LANDING BLVD APT 7104
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7767
Practice Address - Country:US
Practice Address - Phone:281-704-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical