Individual
MICHAEL ANTHONY SORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3593 E GRANDE BLVD, TYLER, TX 75707-1400
(903) 839-2585
Mailing address
PO BOX 846098, DALLAS, TX 75284-0001
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11546
ZZ
208000000X
Pediatrics Physician
Primary
S8253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1H6148
MEDICARE
TX
05
—
417720601
—
TX
05
—
417720602
—
TX
Enumeration date
06/01/2016
Last updated
04/05/2021
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