Healthcare Provider Details

I. General information

NPI: 1376647727
Provider Name (Legal Business Name): SOLEDAD L HORNBAKER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOLEDAD LECHUGA R.N.

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 RIVERA
EL PASO TX
79905
US

IV. Provider business mailing address

3607 RIVERA
EL PASO TX
79905
US

V. Phone/Fax

Practice location:
  • Phone: 915-533-7057
  • Fax: 915-533-7197
Mailing address:
  • Phone: 915-533-7057
  • Fax: 915-533-7197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number253919
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: