Provider Demographics
NPI:1740052547
Name:SOLOMON, ERICQUANDA
Entity type:Individual
Prefix:
First Name:ERICQUANDA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 HIGH MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0035
Mailing Address - Country:US
Mailing Address - Phone:542-205-2922
Mailing Address - Fax:
Practice Address - Street 1:3109 HIGH MEADOW ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-0035
Practice Address - Country:US
Practice Address - Phone:542-205-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)