Individual provider Active NPI

Olusegun A Solano, M.D.

  • Psychiatry Physician
  • Fort Worth, TX
National Provider Identifier
1780742445
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H9424 Issued in TX
Practice address
3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277
Phone
(817) 569-4396
Fax
(817) 569-4517
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X H9424 TX Primary

Addresses

Primary practice location

3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277

Mailing address

PO Box 2603
HTN, Client Accounting
Fort Worth, TX 76113-2603
Phone (817) 569-4396

Other identifiers 1

IdentifierTypeStateIssuer
114853803MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080902000129 TX Practitioner - Psychiatry 8123194909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Helen Farabee CentersGroup PAC ID 8729042916, 13 clinicians

Practice addresses (Care Compare)

1000 Brook Ave
Wichita Falls, TX 76301-5007
Phone (940) 397-3143

1000 Brook St
Wichita Falls, TX 76301-5007

500 Broad St
Wichita Falls, TX 76301-3109
Phone (940) 397-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H9424TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Farabee Centers Psychiatry CurrentSince Jul 28, 2008 Accepting new patients

Locations

516 Denver St
Wichita Falls, TX 76301
Phone (940) 720-3500

1000 Brook Ave
Wichita Falls, TX 76301
Phone (940) 397-3100

500 Broad St
Wichita Falls, TX 76301
Phone (940) 397-3300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1780742445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2603",
            "address_2": "HTN, CLIENT ACCOUNTING",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132603",
            "telephone_number": "817-569-4396",
            "fax_number": "817-569-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "address_2": "HTN, CLIENT ACCOUNTING",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-569-4396",
            "fax_number": "817-569-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLANO",
        "first_name": "OLUSEGUN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H9424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114853803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.