Provider Demographics
NPI:1467258756
Name:SOTO, JOSE H III (NNP-BC)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:H
Last Name:SOTO
Suffix:III
Gender:
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6022 AMIR DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-7714
Mailing Address - Country:US
Mailing Address - Phone:956-220-3374
Mailing Address - Fax:
Practice Address - Street 1:6022 AMIR DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-7714
Practice Address - Country:US
Practice Address - Phone:956-220-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104538582363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal