Individual
MS. MARY IMMACULATE SOLOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10223 BROADWAY ST STE P381, PEARLAND, TX 77584-7880
(832) 774-0815
Mailing address
10223 BROADWAY ST STE P381, PEARLAND, TX 77584-7880
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1098622
TX
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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