Provider Demographics
NPI:1194781864
Name:SOLIS, GUILLERMINA (NP)
Entity type:Individual
Prefix:MRS
First Name:GUILLERMINA
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 OSBORNE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1041
Mailing Address - Country:US
Mailing Address - Phone:915-587-9455
Mailing Address - Fax:915-587-9410
Practice Address - Street 1:4930 OSBORNE DR
Practice Address - Street 2:SUITEA
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-1041
Practice Address - Country:US
Practice Address - Phone:915-587-9455
Practice Address - Fax:915-587-9410
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX458197363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L25243OtherMEDICARE PTAN