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General NPI Number Information
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NPI Number | 1295446672
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH SURGERY CENTER LLC
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1505 HARROUN AVE STE 1
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City | MCKINNEY
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State | TX
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Zip | 75069-3433
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Country | US
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Telephone | 972-914-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 HARROUN AVE STE 1
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City | MCKINNEY
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State | TX
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Zip | 75069-3433
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Country | US
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Telephone | 469-313-1016
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GEBUM YU
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Credential |
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Telephone | 580-695-8749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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