MEDICARE: DR. JANICE GEORGE SOMAN D.O.

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	207Q00000X	Family Medicine Physician	P9462	TX

General Provider Information

NPI Number	:	1932498912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE GEORGE SOMAN D.O.

Provider Business Mailing Address
First Line	:	1800 MAIN ST
Second Line	:	APT 1304
City	:	DALLAS
State	:	TX
Zip	:	75201-5202
Country	:	US
Telephone Number	:	918-939-8393
Fax Number	:

Provider Business Practice Location Address
First Line	:	2835 AL LIPSCOMB WAY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215-1647
Country	:	US
Telephone Number	:	214-421-1783
Fax Number	:	214-421-7325

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

Provider Enumeration Date	:	03/30/2011
Last Update Date	:	09/18/2015

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