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General NPI Number Information
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NPI Number | 1396384954
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Entity Type | Organization
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Legal Business Name | SOTA MEDICAL
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Dates
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Enumeration Date | 12/31/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 5380 AUTUMN DR
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3424
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Country | US
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Telephone | 281-346-3480
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Fax | 281-462-4106
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Provider Business Mailing Address
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Address Line | 15530 E BRONCOS PKWY UNIT 100
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City | CENTENNIAL
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State | CO
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Zip | 80112-7111
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Country | US
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Telephone | 281-346-3480
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Fax | 281-462-4106
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | ELIZABETH MARTINEZ
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Credential |
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Telephone | 281-346-3480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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