MEDICARE: SOLLIE HEALTH AND WELLNESS

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1407551310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLLIE HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	12807 HAYNES RD BLDG C-2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77066-1124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12807 HAYNES RD BLDG C-2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77066-1124
Country	:	US
Telephone Number	:	346-200-5880
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RUTH MBURU
Credential	:	APRN
Telephone Number	:	832-665-4820

Provider Enumeration Date	:	03/31/2023
Last Update Date	:	03/31/2023

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Directions to “SOLLIE HEALTH AND WELLNESS ” Practice Location

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