Healthcare Provider Details

I. General information

NPI: 1386653897
Provider Name (Legal Business Name): ANTONIO SOEGAARD-TORRES MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9870 GATEWAY BLVD N STE B1
EL PASO TX
79924-4414
US

IV. Provider business mailing address

9870 GATEWAY BLVD N STE B1
EL PASO TX
79924-4414
US

V. Phone/Fax

Practice location:
  • Phone: 915-751-5571
  • Fax: 915-751-0951
Mailing address:
  • Phone: 915-751-5571
  • Fax: 915-751-0951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberJ9357
License Number StateTX

VIII. Authorized Official

Name: DR. ANTONIO SOEGAARD-TORRES
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 915-751-5571