Individual
JERRY SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1004 W 32ND ST STE 110, AUSTIN, TX 78705-1915
(877) 324-3310
Mailing address
1004 W 32ND ST STE 110, AUSTIN, TX 78705-1915
(877) 324-3310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.074657
IL
2085R0202X
Diagnostic Radiology Physician
0101281510
VA
2085R0202X
Diagnostic Radiology Physician
125.074657
IL
2085R0202X
Diagnostic Radiology Physician
BP10072483
TX
2085R0202X
Diagnostic Radiology Physician
Primary
V7655
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2019
Last updated
08/08/2025
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