Provider Demographics
NPI:1770527384
Name:SOLIS, JOSE ARNULFO (DO)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ARNULFO
Last Name:SOLIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12147 MINGER RD
Mailing Address - Street 2:
Mailing Address - City:KOUNTZE
Mailing Address - State:TX
Mailing Address - Zip Code:77625
Mailing Address - Country:US
Mailing Address - Phone:409-287-3729
Mailing Address - Fax:
Practice Address - Street 1:713 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-2043
Practice Address - Country:US
Practice Address - Phone:409-287-3729
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8048207QA0505X
ORDO21474207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine