Provider Demographics
NPI:1962410266
Name:SOSA-MADRIGALI, MARIA SABRINA (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:SABRINA
Last Name:SOSA-MADRIGALI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHELSEA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6202
Mailing Address - Country:US
Mailing Address - Phone:713-807-1131
Mailing Address - Fax:713-807-1141
Practice Address - Street 1:2 CHELSEA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6202
Practice Address - Country:US
Practice Address - Phone:713-807-1131
Practice Address - Fax:713-807-1141
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105619174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX659717OtherBCBS PROVIDER NUMBER
TX2046146-01Medicaid