Provider Demographics
NPI:1215563820
Name:ADVACARE HC PRACTITIONERS INC
Entity Type:Organization
Organization Name:ADVACARE HC PRACTITIONERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKERE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-273-0899
Mailing Address - Street 1:6306 ARCHER RANCH LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6602
Mailing Address - Country:US
Mailing Address - Phone:832-273-0899
Mailing Address - Fax:
Practice Address - Street 1:6306 ARCHER RANCH LN
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6602
Practice Address - Country:US
Practice Address - Phone:832-273-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251E00000XAgenciesHome Health