Advanced Health Center PLLC
Organization Active NPI Integrative Medicine Physician · Tyler, TX
NPI 1760128995 · NPPES record last updated Aug 15, 2022
Key facts
- NPI
- 1760128995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Integrative Medicine Physician 202D00000X
- Legal business name
- ADVANCED HEALTH CENTER PLLC
- Practice address
- 1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059 - Phone
- (903) 526-4875
- Fax
- (903) 526-4876
- NPI assigned
- May 10, 2022
- Organization subpart
- No
Authorized official
- Name
- Dr. Janet Rene Keais, DO
- Title
- Medical Director
- Phone
- (903) 830-9222
Practitioners 8
-
Chiniqua L Carter, FNP-BC
-
Kimberly L Mabry-Paroline, APRN, NP-C,PMHNP-BC
-
Travis Squyres, APRN
-
Natalie Nicole Starkey, APRN, FNP-C
-
Vance R Hale, AGPCNP
-
J. Chris Hubert, DC
-
Delesa Gabrielle Bradley, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220727000030 | TX | Part B Supplier - Clinic/Group Practice | 6305228131 |
Receives reassigned benefits from 6 practitioners Practice locations: Tyler, TX |
National Provider Directory
Locations
1400 W Southwest Loop 323
Ste 60
Tyler, TX 75701
Phone (903) 526-4875
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Integrative Medicine Physician |
202D00000X | Yes | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059
Mailing address
1400 WSW Loop 323 Ste 60
Tyler, TX 75701-7059
Phone (903) 526-4875
Other providers in Tyler, TX
- Alicia Rose Adkison
- Brandon Chase Adkison
- Rebecca Adricula
- Adult Counseling and Resources, PLLC
- Advanced Eyecare
- Advanced Wellness
- Advanta Genetics LLC
- Afaha M Asangansi
- Afaha M. Asangansi ; Zaria Medical Equipment & Supplies
- Affect Provider Group, P.S.C.
All providers in Tyler, TX · Integrative Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.