Provider Demographics
NPI:1063688380
Name:NEW ADVANCED MEDICAL DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:NEW ADVANCED MEDICAL DIAGNOSTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-981-4946
Mailing Address - Street 1:9896 BISSONNET ST STE 230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8152
Mailing Address - Country:US
Mailing Address - Phone:713-981-4946
Mailing Address - Fax:713-981-4925
Practice Address - Street 1:9896 BISSONNET ST STE 230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8152
Practice Address - Country:US
Practice Address - Phone:713-981-4946
Practice Address - Fax:713-981-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral CareGroup - Multi-Specialty