Provider Demographics
NPI:1801007877
Name:SOTELO, NORMA
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:SOTELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 BOULDER PEAK ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3044
Mailing Address - Country:US
Mailing Address - Phone:210-260-0895
Mailing Address - Fax:210-733-3335
Practice Address - Street 1:3607 BOULDER PEAK ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247
Practice Address - Country:US
Practice Address - Phone:210-896-2070
Practice Address - Fax:210-734-5814
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home