Healthcare Provider Details

I. General information

NPI: 1548512601
Provider Name (Legal Business Name): ALEJANDRO SOSA D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 SHADOW MOUNTAIN DR STE H
EL PASO TX
79912-4714
US

IV. Provider business mailing address

6435 CALLE DEL SOL DR
EL PASO TX
79912-7523
US

V. Phone/Fax

Practice location:
  • Phone: 915-519-1070
  • Fax: 915-895-4299
Mailing address:
  • Phone: 787-381-5717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2908
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number27864
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: