Provider Demographics
NPI:1255576369
Name:ADVANCED MEDICINE AND REHABILITATION OF TEXAS, INC.
Entity type:Organization
Organization Name:ADVANCED MEDICINE AND REHABILITATION OF TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDARPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-385-6352
Mailing Address - Street 1:5510 ABRAMS RD
Mailing Address - Street 2:112
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5510 ABRAMS RD
Practice Address - Street 2:112
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-2000
Practice Address - Country:US
Practice Address - Phone:214-363-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty