MEDICARE: ALICIA SOTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1164364212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA SOTO

Provider Business Mailing Address
First Line	:	17350 STATE HIGHWAY 249 STE 220
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-1132
Country	:	US
Telephone Number	:	346-279-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	10123 SABLE TRAIL CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-5725
Country	:	US
Telephone Number	:	346-279-0329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ ALICIA SOTO ” Practice Location

Language	Start Address	Practice Location

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