Provider Demographics
NPI:1457173528
Name:ADVANCE TELEHEALTH SOLUTIONS
Entity type:Organization
Organization Name:ADVANCE TELEHEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:EGBE
Authorized Official - Last Name:EGBE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP
Authorized Official - Phone:832-929-7575
Mailing Address - Street 1:1511 TEXAS AVE S
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-3328
Mailing Address - Country:US
Mailing Address - Phone:832-929-7575
Mailing Address - Fax:
Practice Address - Street 1:1511 TEXAS AVE S
Practice Address - Street 2:SUITE 231
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-3328
Practice Address - Country:US
Practice Address - Phone:832-929-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service