Provider Demographics
NPI:1821034174
Name:SOSA, VIRGINIA F (OD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:F
Last Name:SOSA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801
Mailing Address - Country:US
Mailing Address - Phone:830-278-2597
Mailing Address - Fax:830-278-4091
Practice Address - Street 1:931 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801
Practice Address - Country:US
Practice Address - Phone:830-278-2597
Practice Address - Fax:830-278-4091
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4876TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103020703Medicaid
TX8F10033Medicare PIN