Provider Demographics
NPI:1740404235
Name:ADVANCED MUSCLE CARE PC
Entity Type:Organization
Organization Name:ADVANCED MUSCLE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:281-496-7246
Mailing Address - Street 1:11231 RICHMOND AVE STE D110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6656
Mailing Address - Country:US
Mailing Address - Phone:281-496-7246
Mailing Address - Fax:281-496-7244
Practice Address - Street 1:11231 RICHMOND AVE STE D110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6656
Practice Address - Country:US
Practice Address - Phone:281-496-7246
Practice Address - Fax:281-496-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017023172M00000X, 225700000X, 261QP3300X
226300000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017023OtherLICENSE