Provider Demographics
NPI:1003858424
Name:SOLECKI, BRIAN M (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:SOLECKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 1-1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4433
Mailing Address - Country:US
Mailing Address - Phone:361-993-6011
Mailing Address - Fax:361-993-7939
Practice Address - Street 1:4300 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 1-1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4433
Practice Address - Country:US
Practice Address - Phone:361-993-6011
Practice Address - Fax:361-993-7939
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist