Provider Demographics
NPI:1073167474
Name:SOLANO, LUCIA ROSARIO
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:ROSARIO
Last Name:SOLANO
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 1:9260 BLUECREST DRIVE
Mailing Address - Street 2:APT 4137
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9260 BLUECREST DR APT 4137
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3174
Practice Address - Country:US
Practice Address - Phone:254-459-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119646225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist