Organization · NPI-2

Advanced Lifestyle Solutions PLLC

General Practice · Oklahoma City, OK

NPI number1164026845
StatusActive
Last updated in NPPESJan 10, 2022

Details

NPI
1164026845
Entity type
Organization (NPI-2)
Legal business name
Advanced Lifestyle Solutions PLLC
Organization subpart
No
Enumeration date
Nov 24, 2020
Certification date
Jan 10, 2022
Last updated
Jan 10, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice––Yes
207R00000X Internal Medicine––

Practice location

5252 N Meridian Ave
Oklahoma City, OK 73112-2178

Phone 405-754-5400 · Fax 405-754-5404

Mailing address

1162 Honey Crk
New Braunfels, TX 78132-3453

Phone 214-310-6763

Authorized official

Rita Pannell
Operations Manager
2143106763

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