Provider Demographics
NPI:1124508882
Name:SOLIS, ALFREDO (PTA)
Entity type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 E CORNELIA CIR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78408-2833
Mailing Address - Country:US
Mailing Address - Phone:361-548-6383
Mailing Address - Fax:
Practice Address - Street 1:733 E CORNELIA CIR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78408-2833
Practice Address - Country:US
Practice Address - Phone:361-548-6383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty