Provider Demographics
NPI:1497716393
Name:SOLIS, TANYA M (MD)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:M
Last Name:SOLIS
Suffix:
Gender:F
Credentials:MD
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 4550
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75802-4550
Mailing Address - Country:US
Mailing Address - Phone:903-723-0600
Mailing Address - Fax:903-723-6006
Practice Address - Street 1:3201 S LOOP 256
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-6901
Practice Address - Country:US
Practice Address - Phone:903-723-0600
Practice Address - Fax:903-723-6006
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5569208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5243150001OtherMEDICARE DME
TX154507102Medicaid
TX5243150001OtherMEDICARE DME
H74206Medicare UPIN
TX8A1566Medicare PIN