Provider Demographics
NPI:1124176458
Name:ARMENDARIZ, SOLEDAD (PT)
Entity type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:ARMENDARIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 DEW DR STE 300
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3912
Mailing Address - Country:US
Mailing Address - Phone:915-587-4081
Mailing Address - Fax:915-587-8344
Practice Address - Street 1:6151 DEW DR STE 300
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3912
Practice Address - Country:US
Practice Address - Phone:915-587-4081
Practice Address - Fax:915-587-8344
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1030997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456749Medicare ID - Type Unspecified