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General NPI Number Information
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NPI Number | 1770722811
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Entity Type | Individual
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Provider Name | MS. LISA ANNETTE SOTO
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 300 S STAGECOACH TRL
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City | SAN MARCOS
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State | TX
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Zip | 78666-5096
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Country | US
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Telephone | 512-392-9440
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Fax |
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Provider Business Mailing Address
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Address Line | 116 REI TANG LOOP
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City | KYLE
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State | TX
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Zip | 78640-5331
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Country | US
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Telephone | 512-626-7240
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Fax | 512-268-1328
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1416043
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License Number State | TX
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