MEDICARE: AVANT MEDICAL GROUP, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	8699	TX
2	2083X0100X	Occupational Medicine Physician	K4259	TX
3	208100000X	Physical Medicine & Rehabilitation Physician	8699	TX

General Provider Information

NPI Number	:	1205134087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVANT MEDICAL GROUP, PA

Provider Business Mailing Address
First Line	:	5718 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-5506
Country	:	US
Telephone Number	:	713-785-2667
Fax Number	:	713-785-2659

Provider Business Practice Location Address
First Line	:	2918 SAN JACINTO ST
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77004-2708
Country	:	US
Telephone Number	:	713-652-3145
Fax Number	:	713-652-3146

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	SHAHID H. SYED
Credential	:	M.D.
Telephone Number	:	713-785-2667

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	03/03/2011

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Directions to “AVANT MEDICAL GROUP, PA ” Practice Location

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