Provider Demographics
NPI:1487722849
Name:ADVANCED AMBULATORY, INC.
Entity type:Organization
Organization Name:ADVANCED AMBULATORY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:PUPELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-528-9998
Mailing Address - Street 1:PO BOX 981047
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-8047
Mailing Address - Country:US
Mailing Address - Phone:713-528-9998
Mailing Address - Fax:713-528-9996
Practice Address - Street 1:2211 NORFOLK #1110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098
Practice Address - Country:US
Practice Address - Phone:713-528-9998
Practice Address - Fax:713-528-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical