Organization
ISAAC SOSA M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN ROSE CHAMPAGNE-MILLER CPC (ADMINISTRATOR)
(512) 225-6345
Entity
Organization
Contact information
Practice address
1195 GARNER FIELD RD, STE. 400, UVALDE, TX 78801-4822
(830) 278-6265
(830) 278-6286
Mailing address
PO BOX 1288, UVALDE, TX 78802-1288
(830) 278-6265
(830) 278-6286
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
H7829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00060N
BCBS
TX
05
—
079736701
—
TX
01
—
110225317
MEDICARE RAILROAD
TX
05
—
138814206
—
TX
01
—
86590N
BCBS
TX
01
—
CH4353
MEDICARE RAILROAD
TX
Enumeration date
07/25/2007
Last updated
10/04/2012
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