Individual ProviderJesus Alonso Baca SotoStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3601 4th Street / Stop #: 9410, Lubbock, TX 79430(806) 743-3641PECOS EnrollmentBased on the most recent information from CMS, provider Jesus Alonso Baca Soto does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1790576742Provider TypeIndividualFull NameBaca Soto, Jesus AlonsoCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/16/2025Last Updated5/16/2025Contact InformationPractice LocationPractice Address3601 4th Street / Stop #: 9410, Lubbock, TX 79430Phone(806) 743-3641FaxUnlisted FaxMailing LocationMailing Address3601 4th Street / Stop #: 9410, Lubbock, TX 79430Phone(806) 743-3641FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerTexas