Provider Demographics
NPI:1700196292
Name:OSCAR SOTELO MD PA
Entity Type:Organization
Organization Name:OSCAR SOTELO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-1591
Mailing Address - Street 1:7012 N 10TH ST
Mailing Address - Street 2:STE 40
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3397
Mailing Address - Country:US
Mailing Address - Phone:956-682-1591
Mailing Address - Fax:956-682-1592
Practice Address - Street 1:7012 N 10TH ST
Practice Address - Street 2:STE 40
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3397
Practice Address - Country:US
Practice Address - Phone:956-682-1591
Practice Address - Fax:956-682-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5212174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1155491-03Medicaid
TX282271001OtherGROUP MEDICAID NO.
TXCS2639OtherRR MEDICARE
0068WAOtherBCBS
TXTXB116248Medicare PIN
TX1155491-03Medicaid
TXTXB116247Medicare PIN
TXB26589Medicare UPIN