Provider Demographics
NPI:1508286063
Name:SOLIS, JAICUS KAINOA (MD)
Entity Type:Individual
Prefix:DR
First Name:JAICUS
Middle Name:KAINOA
Last Name:SOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-5131
Mailing Address - Country:US
Mailing Address - Phone:877-440-8326
Mailing Address - Fax:
Practice Address - Street 1:2237 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5131
Practice Address - Country:US
Practice Address - Phone:325-481-2292
Practice Address - Fax:325-481-2023
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0138207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program