Soul Foundation Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUL FOUNDATION INC

Doing business as

Soul Clinics

Practice address

1111 5TH Ave
Fort Worth, TX 76104-4302

Phone

(702) 722-7177

NPI assigned

Nov 2, 2022

Last updated

Nov 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rick Saga

Title

President

Phone

(901) 501-7242

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Soul Clinics Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1265149892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 N TARRANT PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 5TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044302",
            "telephone_number": "702-722-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "SAGA",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-501-7242"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FILE NUMBER SECRETARY OF STATE",
            "identifier": "804566904",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.soulfoundationusa.org",
            "affiliation": "N",
            "address_1": "1111 5th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Soul Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Marie Sotile, RN, BSN
• Steven B Sotman, M.D.
• Brenda Soto
• Erica Soto, LPC
• Rachel Marie Souers, M.D.
• Kathryn Soule, PHD, LPC
• Soumava Sen, DDS, P.C.
• Soumava Sen, DDS, P.C.
• Soumava Sen, DDS, P.C.
• Sound Inpatient Physicians of Texas 1, Inc

• Health Service Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Health Service Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.