MEDICARE: DR. MARILYN SOTO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		TX
2	363LF0000X	Family Nurse Practitioner	1190082	TX

General Provider Information

NPI Number	:	1124804323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN SOTO APRN

Provider Business Mailing Address
First Line	:	2919 APACHE LOOP
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-8914
Country	:	US
Telephone Number	:	254-338-6841
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 S ANN BLVD
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-1260
Country	:	US
Telephone Number	:	254-338-6841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2023
Last Update Date	:	02/06/2025

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