Healthcare Provider Details

I. General information

NPI: 1659702934
Provider Name (Legal Business Name): SOLEJA HOME VISITS MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6417 MEMORIAL DR SUITE A
TEXAS CITY TX
77591-4058
US

IV. Provider business mailing address

1515 HERITAGE DRIVE SUITE 110
MCKINNEY TX
75069-3379
US

V. Phone/Fax

Practice location:
  • Phone: 832-926-2153
  • Fax: 855-814-8428
Mailing address:
  • Phone: 972-616-4702
  • Fax: 855-814-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NUSRAT SOLEJA
Title or Position: SOLE OWNER/ PRESIDENT
Credential: MD
Phone: 281-229-1870