MEDICARE: ADVANCED FUNCTIONAL ASSESSMENTS INC

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	261QP2000X	Physical Therapy Clinic/Center		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7683311	OTHER	TX	AETNA
2	0019HC	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1053318840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FUNCTIONAL ASSESSMENTS INC

Provider Business Mailing Address
First Line	:	3333 BAYSHORE BLVD
Second Line	:	SUITE 350
City	:	PASADENA
State	:	TX
Zip	:	77504-1952
Country	:	US
Telephone Number	:	713-943-1100
Fax Number	:	713-943-1178

Provider Business Practice Location Address
First Line	:	3333 BAYSHORE BLVD
Second Line	:	SUITE 350
City	:	PASADENA
State	:	TX
Zip	:	77504-1952
Country	:	US
Telephone Number	:	713-943-1100
Fax Number	:	713-943-1178

Authorized Official
Title or Position	:	OWNER PHYSICAL THERAPIST DIRECTOR
Name	:	DR. CLINTON W FOSTER
Credential	:	DPT
Telephone Number	:	713-943-1100

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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Directions to “ADVANCED FUNCTIONAL ASSESSMENTS INC ” Practice Location

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