Nadeen Lucero Soederbaum MD PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NADEEN LUCERO SOEDERBAUM MD PLLC

Practice address

903 Medical Centre Dr Ste B
Arlington, TX 76012-4754

Phone

(682) 220-9646

Fax

(580) 297-9236

NPI assigned

Jun 21, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nadeen Lucero Soederbaum, MDNPI 1821439274

Title

Member

Phone

(817) 823-4290

Specialties & licenses 1

Addresses

Other names 1

• Liv Med Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nadeen Lucero Soederbaum, M.D.

  • Family Medicine Physician
  • Mansfield, TX
  • NPI 1821439274
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1194456038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6017 LAKEHURST CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760161025",
            "telephone_number": "817-823-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MEDICAL CENTRE DR STE B",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124754",
            "telephone_number": "682-220-9646",
            "fax_number": "580-297-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NADEEN LUCERO SOEDERBAUM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "SOEDERBAUM",
        "authorized_official_first_name": "NADEEN",
        "authorized_official_middle_name": "LUCERO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "817-823-4290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liv Med",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Arlington, TX
• Providers in Arlington, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.