Provider Demographics
NPI:1174182943
Name:YNIGUEZ, SOLOMON JOSEPH (LMSW)
Entity Type:Individual
Prefix:
First Name:SOLOMON
Middle Name:JOSEPH
Last Name:YNIGUEZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 E T C JESTER BLVD STE 278
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1449
Mailing Address - Country:US
Mailing Address - Phone:713-534-1712
Mailing Address - Fax:713-583-8850
Practice Address - Street 1:2500 E T C JESTER BLVD STE 278
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1449
Practice Address - Country:US
Practice Address - Phone:713-534-1712
Practice Address - Fax:713-583-8850
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66917171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator