Provider Demographics
NPI:1265726038
Name:SOLIS, ENRIQUE (PHARM D)
Entity type:Individual
Prefix:MR
First Name:ENRIQUE
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 S EASTERN AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2578
Mailing Address - Country:US
Mailing Address - Phone:702-929-2229
Mailing Address - Fax:702-929-2951
Practice Address - Street 1:3550 S RAINBOW BLVD
Practice Address - Street 2:T-0850
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1004
Practice Address - Country:US
Practice Address - Phone:702-252-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16972183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacist