Organization
ADVANCED LIFESTYLE SOLUTIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA PANNELL (OPERATIONS MANAGER)
(214) 310-6763
Entity
Organization
Contact information
Practice address
5252 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2178
(405) 754-5400
(405) 754-5404
Mailing address
1162 HONEY CRK, NEW BRAUNFELS, TX 78132-3453
(214) 310-6763
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
01/10/2022
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