Healthcare Provider Details

I. General information

NPI: 1760461099
Provider Name (Legal Business Name): FERNANDO SOSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7210 MCPHERSON AVE SUITE 117
LAREDO TX
78041-6507
US

IV. Provider business mailing address

7210 MCPHERSON AVE SUITE 117
LAREDO TX
78041-6507
US

V. Phone/Fax

Practice location:
  • Phone: 956-795-8510
  • Fax: 956-795-8513
Mailing address:
  • Phone: 956-795-8510
  • Fax: 956-795-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTXL3137
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: