Provider Demographics
NPI:1538195573
Name:SOLANO, VICENTE JR (RN RPSGT)
Entity type:Individual
Prefix:MR
First Name:VICENTE
Middle Name:
Last Name:SOLANO
Suffix:JR
Gender:M
Credentials:RN RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 985
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-0985
Mailing Address - Country:US
Mailing Address - Phone:956-702-9700
Mailing Address - Fax:956-702-9704
Practice Address - Street 1:1211 N RAUL LONGORIA RD
Practice Address - Street 2:STE E
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589
Practice Address - Country:US
Practice Address - Phone:956-702-9700
Practice Address - Fax:956-702-9704
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573705163W00000X
TX9686173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173F00000XOther Service ProvidersSleep Specialist, PhD
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1538195573OtherNPPES
TX573705OtherBOARD OF NURSE EXAMINERS FOR THE STATE OF TEXAS
TX9686OtherBOARD OF POLYSOMNOGRAPHIC TECHNOLOGISTS