Provider Demographics
NPI:1952639718
Name:SOLIS, SAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAL
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5781 KYLE PKWY
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6111
Mailing Address - Country:US
Mailing Address - Phone:512-268-5749
Mailing Address - Fax:512-268-6973
Practice Address - Street 1:5781 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6111
Practice Address - Country:US
Practice Address - Phone:512-268-5749
Practice Address - Fax:512-268-6973
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist