Provider Demographics
NPI:1275300741
Name:SOLACE MINDCARE HUB PLLC
Entity Type:Organization
Organization Name:SOLACE MINDCARE HUB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIS JR
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:956-395-2743
Mailing Address - Street 1:161 S TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6103
Mailing Address - Country:US
Mailing Address - Phone:956-395-2743
Mailing Address - Fax:
Practice Address - Street 1:161 S TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6103
Practice Address - Country:US
Practice Address - Phone:956-395-2743
Practice Address - Fax:956-394-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty