Healthcare Provider Details

I. General information

NPI: 1073608667
Provider Name (Legal Business Name): INNA SOLODKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 MILLS AVE
AUSTIN TX
78731-6309
US

IV. Provider business mailing address

PO BOX 26726
AUSTIN TX
78755-0726
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-4083
  • Fax: 512-324-4717
Mailing address:
  • Phone: 512-407-8686
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM0281
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM0281
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: