Healthcare Provider Details

I. General information

NPI: 1649865981
Provider Name (Legal Business Name): ADVANCED COLON CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PROFESSIONAL PARK DR
WEBSTER TX
77598-4123
US

IV. Provider business mailing address

1407 BLAKELY GROVE LN
PEARLAND TX
77581-3553
US

V. Phone/Fax

Practice location:
  • Phone: 281-957-5655
  • Fax: 281-666-8188
Mailing address:
  • Phone: 832-626-5164
  • Fax: 281-666-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHUMMED RADWAN KHANI
Title or Position: OWNER
Credential:
Phone: 281-957-5655