Provider Demographics
NPI:1962061994
Name:SOLIZ, ANNETTE
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:SOLIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 E EARLING RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-5173
Mailing Address - Country:US
Mailing Address - Phone:956-685-1033
Mailing Address - Fax:
Practice Address - Street 1:654 E EARLING RD STE 1
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-5173
Practice Address - Country:US
Practice Address - Phone:956-685-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-08-06
Deactivation Date:2019-07-01
Deactivation Code:
Reactivation Date:2019-08-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies