Provider Demographics
NPI:1851736052
Name:ADVANCED MEDICAL SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SPECIALISTS, PLLC
Other - Org Name:ADVANCED GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:N
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-764-9500
Mailing Address - Street 1:PO BOX 95400
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76099-9734
Mailing Address - Country:US
Mailing Address - Phone:281-764-9500
Mailing Address - Fax:281-764-9501
Practice Address - Street 1:26103 I-45 NORTH, SUITE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1902
Practice Address - Country:US
Practice Address - Phone:281-764-9500
Practice Address - Fax:281-764-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty