Provider Demographics
NPI:1669688032
Name:SOTOMAYOR, JOSE FRANCISCO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FRANCISCO
Last Name:SOTOMAYOR
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 1:6532 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-2434
Mailing Address - Country:US
Mailing Address - Phone:713-926-6458
Mailing Address - Fax:713-923-2462
Practice Address - Street 1:6532 CANAL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-2434
Practice Address - Country:US
Practice Address - Phone:713-926-6458
Practice Address - Fax:713-923-2462
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3463207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111415902Medicaid
TX111415901Medicaid
TX111415901Medicaid
TX00JV29Medicare ID - Type Unspecified
TXTXB126351Medicare PIN