Provider Demographics
NPI:1225118706
Name:HOWARD D SOLOMON MD PA
Entity Type:Organization
Organization Name:HOWARD D SOLOMON MD PA
Other - Org Name:SEGUIN UROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-379-3046
Mailing Address - Street 1:1255 ASHBY ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5118
Mailing Address - Country:US
Mailing Address - Phone:830-379-3046
Mailing Address - Fax:830-379-8552
Practice Address - Street 1:1255 ASHBY ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5118
Practice Address - Country:US
Practice Address - Phone:830-379-3046
Practice Address - Fax:830-379-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169108101Medicaid
TXDC0028OtherRAILROAD MEDICARE
TX0068LTOtherBLUE CROSS BLUE SHIELD
TX0068LTOtherBLUE CROSS BLUE SHIELD
TX0609670001Medicare NSC