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General NPI Number Information
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NPI Number | 1588429625
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALING SOLUTIONS, PLLC
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 105 FM 911 S
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City | AVERY
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State | TX
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Zip | 75554-5678
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Country | US
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Telephone | 903-215-8039
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Fax | 903-213-9047
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Provider Business Mailing Address
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Address Line | 370 UTAH ST
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City | AVERY
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State | TX
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Zip | 75554-2600
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Country | US
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Telephone | 903-908-0352
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Fax | 903-213-9047
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Authorized Official
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Title or Position | OWNER
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Name | MRS. STACEY ERVIN
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Credential | NP
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Telephone | 903-908-0352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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