Provider Demographics
NPI:1255048724
Name:SOMA MD PLLC
Entity type:Organization
Organization Name:SOMA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VIMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-392-0492
Mailing Address - Street 1:18101 W STATE HIGHWAY 71 STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-2718
Mailing Address - Country:US
Mailing Address - Phone:512-765-6502
Mailing Address - Fax:
Practice Address - Street 1:18101 W STATE HIGHWAY 71 STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-2718
Practice Address - Country:US
Practice Address - Phone:512-765-6502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty