=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346026515
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOL CENTER THERAPY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2023
-----------------------------------------------------
Last Update Date | 01/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3333 COUNTY ROAD 119 STE 40
-----------------------------------------------------
City | HUTTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78634-1005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-401-3922
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3333 COUNTY ROAD 119 STE 40
-----------------------------------------------------
City | HUTTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78634-1005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | MELISSA COFER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 646-401-3922
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------