Healthcare Provider Details

I. General information

NPI: 1427330588
Provider Name (Legal Business Name): MICHAEL A. SORACE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 FLOYD CURL DR STE 505 MEDICAL CENTER TOWER 1
SAN ANTONIO TX
78229-3924
US

IV. Provider business mailing address

7950 FLOYD CURL DR STE 505 MEDICAL CENTER TOWER 1
SAN ANTONIO TX
78229-3924
US

V. Phone/Fax

Practice location:
  • Phone: 830-331-9900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberN3322
License Number StateTX

VIII. Authorized Official

Name: MICHAEL A. SORACE
Title or Position: PRESIDENT
Credential: MD
Phone: 830-331-9900