Provider Demographics
NPI:1235934142
Name:SOLIS, GRACE (CPHT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:GRACIELA
Other - Middle Name:
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 NE 13TH ST STE 1G
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5040
Mailing Address - Country:US
Mailing Address - Phone:405-271-3445
Mailing Address - Fax:405-271-1531
Practice Address - Street 1:1000 NE 13TH ST STE 1G
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5040
Practice Address - Country:US
Practice Address - Phone:405-271-3445
Practice Address - Fax:405-271-1531
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK30155850183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician