Provider Demographics
NPI:1629269774
Name:SOCOTEANU, MATEI PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MATEI
Middle Name:PAUL
Last Name:SOCOTEANU
Suffix:
Gender:M
Credentials:MD
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:1300 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-4717
Practice Address - Country:US
Practice Address - Phone:903-757-2122
Practice Address - Fax:903-757-9475
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000041364207R00000X, 208M00000X
TXM9018207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202314501Medicaid
TXP00725229OtherRAILROAD MEDICARE
TX8BZ841OtherBLUECROSS BLUESHIELD OF TEXAS
TX8L13259Medicare PIN