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NPI Code Detail

MEDICARE: ADVANCE CARE MEDICAL GROUP, PLLC

MEDICARE: ADVANCE CARE MEDICAL GROUP, PLLC
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
1163W00000XRegistered Nurse
2163WG0000XGeneral Practice Registered Nurse
3163WW0000XWound Care Registered Nurse
4208600000XSurgery Physician
5225100000XPhysical Therapist
6225XG0600XGerontology Occupational Therapist
72278G1100XGeneral Care Certified Respiratory Therapist
8363LF0000XFamily Nurse Practitioner
9207QA0505XAdult Medicine Physician

General Provider Information

NPI Number : 1205528288
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCE CARE MEDICAL GROUP, PLLC
Provider Business Mailing Address
First Line : 801 TRAVIS ST STE 2101
Second Line :
City : HOUSTON
State : TX
Zip : 77002-5730
Country : US
Telephone Number : 956-271-8993
Fax Number : 469-621-2209
Provider Business Practice Location Address
First Line : 801 TRAVIS ST STE 2101
Second Line :
City : HOUSTON
State : TX
Zip : 77002-5730
Country : US
Telephone Number : 956-271-8993
Fax Number : 469-621-2209
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : CARLOS REYES-PESCADOR
Credential : MD
Telephone Number : 956-271-8992
Provider Enumeration Date : 05/25/2023
Last Update Date : 04/11/2024

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Directions to “ADVANCE CARE MEDICAL GROUP, PLLC ” Practice Location

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