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General NPI Number Information
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NPI Number | 1710618723
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Entity Type | Individual
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Provider Name | JOSE SOSA
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Gender | Male
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 7480 PADRE ISLAND HWY
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3449
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Country | US
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Telephone | 956-592-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 W UNIVERSITY DR
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City | EDINBURG
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State | TX
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Zip | 78539-2909
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Country | US
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Telephone | 956-665-7049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | PA16588
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-13208
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA16588
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License Number State | TX
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