Provider Demographics
NPI:1891802732
Name:SOLIS, RICARDO LERMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:LERMA
Last Name:SOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3722
Mailing Address - Country:US
Mailing Address - Phone:512-447-8911
Mailing Address - Fax:512-447-8761
Practice Address - Street 1:4207 JAMES CASEY ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-447-8911
Practice Address - Fax:512-447-8761
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1757208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147422301Medicaid
TX8B9880OtherBCBS PROVIDER NUMBER
TX8L5920Medicare PIN
TXH44511Medicare UPIN
TX00G96PMedicare PIN
TX8455N0Medicare PIN