=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366048456
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOLEDAD COLEMAN FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2020
-----------------------------------------------------
Last Update Date | 07/25/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 226 E. RICE STREET
-----------------------------------------------------
City | FALFURRIAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78355
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-360-0844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1209 S 10TH ST STE A757
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-5059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-360-0844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 885232
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------