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General NPI Number Information
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NPI Number | 1871475913
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PSYCHIATRY, P.A.
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 312 W LEUDA ST
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City | FORT WORTH
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State | TX
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Zip | 76104-3306
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Country | US
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Telephone | 682-200-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 312 W LEUDA ST
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City | FORT WORTH
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State | TX
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Zip | 76104-3306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRIAN DIXON
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Credential | MD
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Telephone | 844-387-7924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084S0010X
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Taxonomy Name | Sports Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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