# ADVANCED LIFESTYLE SOLUTIONS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164026845
- **Authorized official:** RITA PANNELL (OPERATIONS MANAGER)
- **Authorized official phone:** (214) 310-6763

## Contact information

- **Practice address:** 5252 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2178
- **Practice address phone:** (405) 754-5400
- **Practice address fax:** (405) 754-5404
- **Mailing address:** 1162 HONEY CRK, NEW BRAUNFELS, TX 78132-3453
- **Mailing address phone:** (214) 310-6763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/24/2020
- **Last updated:** 01/10/2022