Wellness of South Texas LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

Legal business name

WELLNESS OF SOUTH TEXAS LLC

Practice address

107 Calle del Norte # 19
Laredo, TX 78041-9104

Phone

(956) 766-7585

Fax

(956) 435-0290

NPI assigned

Jun 21, 2023

Last updated

Oct 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Russell Solis

Title

Manager

Phone

(956) 605-6420

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1821773300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 E 9TH ST STE 14",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785725465",
            "telephone_number": "956-580-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CALLE DEL NORTE # 19",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780419104",
            "telephone_number": "956-766-7585",
            "fax_number": "956-435-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OF SOUTH TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "SOLIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "956-605-6420",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Laredo, TX
• Providers in Laredo, TX by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.