Provider Demographics
NPI:1821077074
Name:SOLOMON, CARL D (DPM)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:D
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 GASTON AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1541
Mailing Address - Country:US
Mailing Address - Phone:214-824-3851
Mailing Address - Fax:214-824-3852
Practice Address - Street 1:3801 GASTON AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1541
Practice Address - Country:US
Practice Address - Phone:214-824-3851
Practice Address - Fax:214-824-3852
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-14
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0411213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L474OtherMEDICARE ID
TX00831001Medicaid
TXT16015Medicare UPIN