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NPI Code Detail

MEDICARE: AMANDA VICTORIA SOZA MD

MEDICARE: AMANDA VICTORIA SOZA MD
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
1208000000XPediatrics PhysicianS7146TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790215002
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA VICTORIA SOZA MD
Provider Business Mailing Address
First Line : 6210 E HIGHWAY 290 STE 420
Second Line :
City : AUSTIN
State : TX
Zip : 78723-1142
Country : US
Telephone Number : 512-483-9569
Fax Number : 512-406-6216
Provider Business Practice Location Address
First Line : 22420 IH 35 STE 203
Second Line :
City : KYLE
State : TX
Zip : 78640-2656
Country : US
Telephone Number : 407-649-6876
Fax Number : 407-872-0544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2017
Last Update Date : 03/12/2021

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Directions to “ AMANDA VICTORIA SOZA MD” Practice Location

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