Individual
MARY S SODERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1460 WALNUT ST, COLUMBUS, TX 78934-2131
(979) 732-6204
Mailing address
4910 AIRPORT AVE, BLDG D, ROSENBERG, TX 77471-5759
(281) 239-1369
(281) 239-0828
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J0896
TX
Other
Enumeration date
08/31/2006
Last updated
07/09/2007
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