Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | Q2205 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | Q2205 | TX |
NPI | 1285901140 |
---|---|
Provider Name | Michael Soler |
First Address | Portland, TX 78374-2935 |
Second Address | Portland, TX 78374-2935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2011 |
Last Update Date | 17/10/2014 |