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NPI Code Detail

MEDICARE: MARK SODDERS L.AC.

MEDICARE:   MARK  SODDERS  L.AC.
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
1171100000XAcupuncturistAC00864TX
2171100000XAcupuncturistAC14411CA

General Provider Information

NPI Number : 1730360454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK SODDERS L.AC.
Provider Business Mailing Address
First Line : 9041 GARLAND RD
Second Line :
City : DALLAS
State : TX
Zip : 75218-3919
Country : US
Telephone Number : 972-454-9341
Fax Number :
Provider Business Practice Location Address
First Line : 9041 GARLAND RD
Second Line :
City : DALLAS
State : TX
Zip : 75218-3919
Country : US
Telephone Number : 972-454-9341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2007
Last Update Date : 12/16/2015

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Directions to “ MARK SODDERS L.AC.” Practice Location

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