Provider Demographics
NPI:1154192615
Name:SORIA, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:SORIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W EXCHANGE PKWY STE 2120
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-7116
Mailing Address - Country:US
Mailing Address - Phone:945-758-3273
Mailing Address - Fax:
Practice Address - Street 1:1010 W EXCHANGE PKWY STE 2120
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-7116
Practice Address - Country:US
Practice Address - Phone:945-758-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor