Individual
KELLY SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2358
(832) 824-1000
Mailing address
6621 FANNIN ST, HOUSTON, TX 77030-2358
(832) 824-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202005610
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
1153742
TX
363LP0200X
Pediatric Nurse Practitioner
1153742
TX
Other
Enumeration date
06/22/2018
Last updated
09/16/2024
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