Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PD573 | TX |
N | 222Z00000X | Podiatrist | PD573 | TX |
N | 2081S0010X | Sports Medicine | PD573 | TX |
N | 213ES0000X | Sports Medicine | PD573 | TX |
Y | 213ES0103X | Foot & Ankle Surgery | PD573 | TX |
NPI | 1134196421 |
---|---|
Provider Name | Dr. Ronald P Soefer |
First Address | Houston, TX 77024-2545 |
Second Address | Houston, TX 77024-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2006 |
Last Update Date | 15/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018620701 | (05) | TX |
4075952 | AETNA PROVIDER (01) | TX |
AL38 | BCBS PROVIDER (01) | TX |
T16010 | (02) | TX |