Provider Demographics
NPI:1346056371
Name:DEL SOL SOSA, JUAN MIGUEL
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:MIGUEL
Last Name:DEL SOL SOSA
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 1:920 W PIONEER PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6330
Mailing Address - Country:US
Mailing Address - Phone:682-259-7190
Mailing Address - Fax:682-259-7191
Practice Address - Street 1:920 W PIONEER PKWY STE 150
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6330
Practice Address - Country:US
Practice Address - Phone:682-259-7190
Practice Address - Fax:682-259-7191
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1596363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical