Provider Demographics
NPI:1477515153
Name:ADVANCED CARDIOLOGY, INC.
Entity Type:Organization
Organization Name:ADVANCED CARDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-0100
Mailing Address - Street 1:905 SAHARA TRL
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3687
Mailing Address - Country:US
Mailing Address - Phone:330-726-0100
Mailing Address - Fax:330-726-2169
Practice Address - Street 1:905 SAHARA TRL
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3687
Practice Address - Country:US
Practice Address - Phone:330-726-0100
Practice Address - Fax:330-726-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0580134Medicaid
OH0580134Medicaid