MEDICARE: J RAUL SOTO MD PA

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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0078JA	OTHER	TX	BCBS
3	2804832	OTHER	TX	AETNA
4	10016562	OTHER	TX	AMERIGROUP
5	060070473	OTHER	TX	MEDCARE RAILROAD

General Provider Information

NPI Number	:	1275625212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J RAUL SOTO MD PA

Provider Business Mailing Address
First Line	:	7789 SOUTHWEST FWY, STE 420
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074
Country	:	US
Telephone Number	:	713-580-0234
Fax Number	:	713-580-0259

Provider Business Practice Location Address
First Line	:	7789 SOUTHWEST FWY, STE 420
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1833
Country	:	US
Telephone Number	:	713-580-0234
Fax Number	:	713-580-0259

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MARY MONTOYA
Credential	:	CMC
Telephone Number	:	713-580-0234

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	09/11/2008

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