MEDICARE: SOLOMON JOSEPH YNIGUEZ LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	66917	TX

General Provider Information

NPI Number	:	1174182943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLOMON JOSEPH YNIGUEZ LMSW

Provider Business Mailing Address
First Line	:	2500 E T C JESTER BLVD STE 278
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1449
Country	:	US
Telephone Number	:	713-534-1712
Fax Number	:	713-583-8850

Provider Business Practice Location Address
First Line	:	2500 E T C JESTER BLVD STE 278
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1449
Country	:	US
Telephone Number	:	713-534-1712
Fax Number	:	713-583-8850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2019
Last Update Date	:	06/06/2019

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