Provider Demographics
NPI:1912616905
Name:DEL SOL MEDICAL LLC
Entity Type:Organization
Organization Name:DEL SOL MEDICAL LLC
Other - Org Name:DEL SOL MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GARZA
Authorized Official - Last Name:RODRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:505-364-6804
Mailing Address - Street 1:6070 GATEWAY BLVD E STE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2027
Mailing Address - Country:US
Mailing Address - Phone:915-228-3665
Mailing Address - Fax:915-228-3666
Practice Address - Street 1:6070 GATEWAY BLVD E STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2027
Practice Address - Country:US
Practice Address - Phone:915-228-3665
Practice Address - Fax:915-228-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF0915581OtherAANP CERTIFICATE