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General NPI Number Information
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NPI Number | 1295127355
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Entity Type | Organization
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Legal Business Name | SOLACE WOMENS CARE PA
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Dates
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Enumeration Date | 02/26/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 690 S LOOP 336 W 220
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City | CONROE
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State | TX
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Zip | 77304-3319
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Country | US
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Telephone | 936-441-7100
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Fax | 936-756-7105
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Provider Business Mailing Address
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Address Line | 690 S LOOP 336 W 220
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City | CONROE
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State | TX
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Zip | 77304-3319
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Country | US
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Telephone | 936-441-7100
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Fax | 936-756-7105
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Authorized Official
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Title or Position | MD
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Name | FARLY SEJOUR
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Credential |
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Telephone | 936-441-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | P5469
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License Number State | TX
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