MEDICARE: OMID SOLTANI PMHNP-BC, RN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1125866	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538161815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMID SOLTANI PMHNP-BC, RN

Provider Business Mailing Address
First Line	:	1500 S DAIRY ASHFORD RD STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3858
Country	:	US
Telephone Number	:	281-208-7414
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S DAIRY ASHFORD RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3854
Country	:	US
Telephone Number	:	281-208-7414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/26/2024

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