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General NPI Number Information
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NPI Number | 1871100438
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTHCARE PRACTICE LLC
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 6140 N SAM HOUSTON PKWY W
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City | HOUSTON
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State | TX
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Zip | 77066-5002
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Country | US
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Telephone | 832-519-8093
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Fax | 832-218-3378
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Provider Business Mailing Address
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Address Line | 7422 SHADY LAKE GRV
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City | RICHMOND
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State | TX
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Zip | 77407-3181
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Country | US
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Telephone | 832-519-8093
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Fax | 832-218-3378
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. FAUSKA BASHABE
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Credential |
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Telephone | 313-712-6763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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