Provider Demographics
NPI:1326093618
Name:TOTSOL, INC.
Entity Type:Organization
Organization Name:TOTSOL, INC.
Other - Org Name:THE PEOPLE'S HEALTH & WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:U
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:903-581-5515
Mailing Address - Street 1:1404 RICE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703
Mailing Address - Country:US
Mailing Address - Phone:903-581-5515
Mailing Address - Fax:903-581-5506
Practice Address - Street 1:1404 RICE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703
Practice Address - Country:US
Practice Address - Phone:903-581-5515
Practice Address - Fax:903-581-5506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTSOL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-24
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0403046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00745NMedicare PIN