Provider Demographics
NPI:1760597470
Name:TABET, ADELAIDA SOTOMAYOR (MD)
Entity Type:Individual
Prefix:MRS
First Name:ADELAIDA
Middle Name:SOTOMAYOR
Last Name:TABET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MAIN
Mailing Address - Street 2:STE 520
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-222-9196
Mailing Address - Fax:210-222-9170
Practice Address - Street 1:730 N MAIN
Practice Address - Street 2:STE 520
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-222-9196
Practice Address - Fax:210-222-9170
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2605208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics