Provider Demographics
NPI:1841871316
Name:SOSA, JORGE
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:SOSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 WAFER ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77506-2431
Mailing Address - Country:US
Mailing Address - Phone:832-748-6583
Mailing Address - Fax:713-979-9138
Practice Address - Street 1:515 WAFER ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77506-2431
Practice Address - Country:US
Practice Address - Phone:832-748-6583
Practice Address - Fax:713-979-9138
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty