Provider Demographics
NPI:1427072610
Name:SOSA, MARIA A (MD)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:A
Last Name:SOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8399
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8399
Mailing Address - Country:US
Mailing Address - Phone:281-364-1707
Mailing Address - Fax:281-364-0028
Practice Address - Street 1:25511 BUDDE RD
Practice Address - Street 2:STE 1201 BELLE BUILDING
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2080
Practice Address - Country:US
Practice Address - Phone:281-364-1707
Practice Address - Fax:281-364-0028
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM24792085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1590648-01OtherMEDICAID GROUP
TX1590473-01OtherMEDICAID GROUP
TX00250TOtherGROUP MEDICARE PIN
P00840676OtherRR MEDICARE PTAN
TX00251TOtherMEDICARE GROUP PIN
7030770OtherAETNA PIN #
TX00250TOtherGROUP MEDICARE PIN
TX00251TOtherMEDICARE GROUP PIN
7030770OtherAETNA PIN #