Provider Demographics
NPI:1659702934
Name:SOLEJA HOME VISITS MHT LLC
Entity Type:Organization
Organization Name:SOLEJA HOME VISITS MHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NUSRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-229-1870
Mailing Address - Street 1:1515 HERITAGE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3379
Mailing Address - Country:US
Mailing Address - Phone:972-616-4702
Mailing Address - Fax:855-814-8428
Practice Address - Street 1:6417 MEMORIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-4058
Practice Address - Country:US
Practice Address - Phone:832-926-2153
Practice Address - Fax:855-814-8428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty