Healthcare Provider Details

I. General information

NPI: 1558673640
Provider Name (Legal Business Name): SOLIZ PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WEST THORNTON STREET
THREE RIVERS TX
78071
US

IV. Provider business mailing address

PO BOX 852
THREE RIVERS TX
78071-0852
US

V. Phone/Fax

Practice location:
  • Phone: 361-786-3001
  • Fax: 361-786-3008
Mailing address:
  • Phone: 361-786-3001
  • Fax: 361-786-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1151381
License Number StateTX

VIII. Authorized Official

Name: MRS. DUSTY SOLIZ
Title or Position: PHYSICAL THERAPIST
Credential: M.S.P.T
Phone: 361-786-3001