Provider Demographics
NPI:1073854360
Name:SOLIZ, KATDIDIA M (PA-C)
Entity Type:Individual
Prefix:
First Name:KATDIDIA
Middle Name:M
Last Name:SOLIZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78333-0850
Mailing Address - Country:US
Mailing Address - Phone:361-664-0303
Mailing Address - Fax:866-845-0933
Practice Address - Street 1:230 S GULF ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4310
Practice Address - Country:US
Practice Address - Phone:361-664-0303
Practice Address - Fax:866-845-0933
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant