Provider Demographics
NPI:1023210119
Name:AVANT MEDICAL GROUP PA
Entity Type:Organization
Organization Name:AVANT MEDICAL GROUP PA
Other - Org Name:ALLIED MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:H
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-378-0667
Mailing Address - Street 1:PO BOX 24809
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77229-4809
Mailing Address - Country:US
Mailing Address - Phone:713-378-0667
Mailing Address - Fax:713-300-9990
Practice Address - Street 1:5718 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5506
Practice Address - Country:US
Practice Address - Phone:713-785-2667
Practice Address - Fax:713-785-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7979111N00000X
TX7138111N00000X
TX8504111N00000X
TX8699111N00000X
TX9330111N00000X
TX7231111N00000X
TXK42592083X0100X
TX1135762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty