Provider Demographics
NPI:1447495122
Name:ADVACE CARDIOLOGY GROUP PA
Entity type:Organization
Organization Name:ADVACE CARDIOLOGY GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-773-3353
Mailing Address - Street 1:1975 N VETERANS BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4456
Mailing Address - Country:US
Mailing Address - Phone:830-776-5818
Mailing Address - Fax:830-776-5814
Practice Address - Street 1:1975 N VETERANS BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4456
Practice Address - Country:US
Practice Address - Phone:830-776-5818
Practice Address - Fax:830-776-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty