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General NPI Number Information
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NPI Number | 1982843629
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE MEDICAL REFERAL SERVICES
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 7457 HARWIN DR STE 101
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City | HOUSTON
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State | TX
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Zip | 77036-2025
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Country | US
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Telephone | 713-784-2227
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Fax | 713-784-2295
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Provider Business Mailing Address
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Address Line | 7457 HARWIN DR STE 101
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City | HOUSTON
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State | TX
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Zip | 77036-2025
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Country | US
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Telephone | 713-784-2227
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Fax | 713-784-2295
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Authorized Official
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Title or Position | C E O
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Name | MS. AVIS BROOKS
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Credential |
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Telephone | 713-784-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 20090027365
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License Number State | TX
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