MEDICARE: CLINICA DEL SOL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	E7615	TX

General Provider Information

NPI Number	:	1285802884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA DEL SOL PA

Provider Business Mailing Address
First Line	:	6206 DASHWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4214
Country	:	US
Telephone Number	:	713-778-1904
Fax Number	:

Provider Business Practice Location Address
First Line	:	6206 DASHWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4214
Country	:	US
Telephone Number	:	713-778-1904
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ADRIANA HANSEN
Credential	:
Telephone Number	:	713-981-1725

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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Directions to “CLINICA DEL SOL PA ” Practice Location

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