Basic Information
| Provider Information | |||||||||
| NPI: | 1629269774 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOCOTEANU | ||||||||
| FirstName: | MATEI | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722342987 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 N 4TH ST | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756014717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037572122 | ||||||||
| FaxNumber: | 9037579475 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 03/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD0000041364 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD0000041364 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RH0003X | M9018 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RX0202X | M9018 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 202314501 | 05 | TX | MEDICAID | P00725229 | 01 | TX | RAILROAD MEDICARE | OTHER | 8BZ841 | 01 | TX | BLUECROSS BLUESHIELD OF TEXAS | OTHER |