MEDICARE: JOSE 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	246ZE0500X	EEG Specialist/Technologist
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	1342	TX

General Provider Information

NPI Number	:	1588080162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE SOTO

Provider Business Mailing Address
First Line	:	7918 WESTINGTON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6148
Country	:	US
Telephone Number	:	832-420-3433
Fax Number	:

Provider Business Practice Location Address
First Line	:	7918 WESTINGTON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6148
Country	:	US
Telephone Number	:	832-420-3433
Fax Number	:

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

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	03/06/2014

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Directions to “ JOSE SOTO ” Practice Location

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