Basic Information
| Provider Information | |||||||||
| NPI: | 1598248866 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOTO | ||||||||
| FirstName: | HILDA | ||||||||
| MiddleName: | AGUADO | ||||||||
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| Credential: | OT | ||||||||
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| OtherLastName: | SOTO | ||||||||
| OtherFirstName: | HILDA | ||||||||
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| OtherCredential: | OT | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 414 MEADOW VIEW DR | ||||||||
| Address2: | |||||||||
| City: | ADKINS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781012652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103801044 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1615 11TH ST | ||||||||
| Address2: | |||||||||
| City: | FLORESVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781142403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302167090 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2018 | ||||||||
| LastUpdateDate: | 09/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 104983 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 104983 | 01 | TX | OCCUPATIONAL THERAPIST | OTHER |