Provider Demographics
NPI:1760128995
Name:ADVANCED HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:ADVANCED HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:KEAIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:903-830-9222
Mailing Address - Street 1:1400 WSW LOOP 323 STE 60
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-7059
Mailing Address - Country:US
Mailing Address - Phone:903-526-4875
Mailing Address - Fax:903-526-4876
Practice Address - Street 1:1400 WSW LOOP 323 STE 60
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-7059
Practice Address - Country:US
Practice Address - Phone:903-526-4875
Practice Address - Fax:903-526-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty