Provider Demographics
NPI:1861881484
Name:SODIPE, PIUS (DPT)
Entity type:Individual
Prefix:
First Name:PIUS
Middle Name:
Last Name:SODIPE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 TIERRA NEGRA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4451
Mailing Address - Country:US
Mailing Address - Phone:915-626-6120
Mailing Address - Fax:915-856-3668
Practice Address - Street 1:11199 PELLICANO DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-5304
Practice Address - Country:US
Practice Address - Phone:915-591-0445
Practice Address - Fax:915-591-0443
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11860082251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1186008OtherPT LICENSE