Organization Active NPI

Solace Womens Care PA

  • Obstetrics & Gynecology Physician
  • Conroe, TX
National Provider Identifier
1295127355
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P5469 Issued in TX
Legal business name
SOLACE WOMENS CARE PA
Practice address
690 S Loop 336 W
220
Conroe, TX 77304-3319
Phone
(936) 441-7100
Fax
(936) 756-7105
NPI assigned
Feb 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Farly SejourNPI 1225107113
Title
MD
Phone
(936) 441-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X P5469 TX Primary

Addresses

Primary practice location

690 S Loop 336 W
220
Conroe, TX 77304-3319

Mailing address

690 S Loop 336 W
220
Conroe, TX 77304-3319
Phone (936) 441-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150421000193 TX Part B Supplier - Clinic/Group Practice 7719205921 Receives reassigned benefits from 2 practitioners
Practice locations: Conroe, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2094974Solace Womens Care PA690 South Loop 336 West Suite 220, Conroe, TX 77304Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Locations

690 S Loop 336 W
Ste 220
Conroe, TX 77304
Phone (936) 441-7100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1295127355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "address_2": "220",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-441-7100",
            "fax_number": "936-756-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "address_2": "220",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-441-7100",
            "fax_number": "936-756-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE WOMENS CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "SEJOUR",
        "authorized_official_first_name": "FARLY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "936-441-7100"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P5469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.