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NPI Code Detail

MEDICARE: PRO HEALTHCARE LLC

MEDICARE: PRO HEALTHCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianP1483TX
2364SA2200XAdult Health Clinical Nurse Specialist696580TX

General Provider Information

NPI Number : 1225479959
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRO HEALTHCARE LLC
Provider Business Mailing Address
First Line : 820 S MACARTHUR BLVD
Second Line : SUITE#105-281
City : COPPELL
State : TX
Zip : 75019-4216
Country : US
Telephone Number : 972-584-7616
Fax Number : 214-853-5364
Provider Business Practice Location Address
First Line : 1420 VALWOOD PKWY
Second Line : SUITE NO. 20-170A
City : CARROLLTON
State : TX
Zip : 75006-8312
Country : US
Telephone Number : 972-584-7616
Fax Number : 214-853-5364
Authorized Official
Title or Position : ADULT CLINICAL NURSE SPECIALIST
Name : FURQAN KHAN
Credential : APRN
Telephone Number : 972-584-7616
Provider Enumeration Date : 07/10/2013
Last Update Date : 04/23/2015

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Directions to “PRO HEALTHCARE LLC ” Practice Location

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