Provider Demographics
NPI:1144091661
Name:SOLIS, BRANDON M (DPT, PT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:M
Last Name:SOLIS
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 AIRPORT FWY STE A
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6777
Mailing Address - Country:US
Mailing Address - Phone:817-858-0390
Mailing Address - Fax:817-858-0842
Practice Address - Street 1:1320 AIRPORT FWY STE A
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6777
Practice Address - Country:US
Practice Address - Phone:817-858-0390
Practice Address - Fax:817-858-0842
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1388900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist