Provider Demographics
NPI:1740585827
Name:SOLIS, RAMON JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:
Last Name:SOLIS
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 BETONY LOOP
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-4408
Mailing Address - Country:US
Mailing Address - Phone:419-610-6829
Mailing Address - Fax:
Practice Address - Street 1:285 BETONY LOOP
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-4408
Practice Address - Country:US
Practice Address - Phone:419-610-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2080600225200000X
TN4848225200000X
OH07599225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant