Provider Demographics
NPI:1619113073
Name:ADVACARDIO PLLC
Entity Type:Organization
Organization Name:ADVACARDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KOZHAYA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOKHON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-533-5333
Mailing Address - Street 1:1125 CYPRESS STATION DR
Mailing Address - Street 2:STE A3
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3054
Mailing Address - Country:US
Mailing Address - Phone:281-533-5333
Mailing Address - Fax:281-533-5335
Practice Address - Street 1:1125 CYPRESS STATION DR
Practice Address - Street 2:STE A3
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3054
Practice Address - Country:US
Practice Address - Phone:281-533-5333
Practice Address - Fax:281-533-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280177101 MONT COMedicaid
TX280177102 HARRIS COMedicaid
TX0A3697 MONT COMedicare PIN
TX280177101 MONT COMedicaid