Individual
ISMAEL TRES SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12414 JUDSON RD, LIVE OAK, TX 78233-3255
(210) 650-9669
(210) 650-0750
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 650-9669
(210) 650-0750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N7970
TX
208M00000X
Hospitalist Physician
Primary
N7970
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220663303
—
TX
01
—
8DL511
BCBSTX
TX
01
—
P01136129
RAILROAD MEDICARE
—
Enumeration date
08/28/2007
Last updated
06/02/2014
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