Provider Demographics
NPI:1619477122
Name:SOLARIN, OMOLADE (RN)
Entity Type:Individual
Prefix:
First Name:OMOLADE
Middle Name:
Last Name:SOLARIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 BELLAIRE BLVD
Mailing Address - Street 2:1721
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-1207
Mailing Address - Country:US
Mailing Address - Phone:832-715-4606
Mailing Address - Fax:
Practice Address - Street 1:5350 BELLAIRE BLVD
Practice Address - Street 2:1721
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77402-1207
Practice Address - Country:US
Practice Address - Phone:832-715-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX935609163WA2000X, 163WC0200X, 163WE0003X, 163WM0705X, 163WP0200X, 163WH0200X
TX234049164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No164X00000XNursing Service ProvidersLicensed Vocational Nurse