Provider Demographics
NPI:1629052568
Name:SOTO, JOEL (SURGICAL TECHNICIAN)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:SOTO
Suffix:
Gender:M
Credentials:SURGICAL TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6770
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6770
Mailing Address - Country:US
Mailing Address - Phone:361-561-3384
Mailing Address - Fax:361-883-0573
Practice Address - Street 1:6118 PARKWAY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414
Practice Address - Country:US
Practice Address - Phone:361-883-2000
Practice Address - Fax:361-883-0573
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX070620246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist