Organization
WELLNESS OF SOUTH TEXAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL SOLIS (MANAGER)
(956) 605-6420
Entity
Organization
Contact information
Practice address
107 CALLE DEL NORTE # 19, LAREDO, TX 78041-9104
(956) 766-7585
(956) 435-0290
Mailing address
1123 E 9TH ST STE 14, MISSION, TX 78572-5465
(956) 580-0913
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
10/29/2024
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