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General NPI Number Information
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NPI Number | 1942519962
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Entity Type | Organization
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Legal Business Name | DR KENT K. SORAJJA MD PA
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 1900 S. COULTER ST. SUITE D
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 806-359-5461
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Fax | 806-359-1075
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Provider Business Mailing Address
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Address Line | 1900 S. COULTER ST. SUITE D
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 806-359-5461
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Fax | 806-359-1075
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENT K. SORAJJA
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Credential | M.D.
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Telephone | 806-359-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | E5945
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License Number State | TX
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