MEDICARE: PROGRESSIVE INTEGRATED 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
1	363LF0000X	Family Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083007728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE INTEGRATED HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	11700 PRESTON RD STE 660
Second Line	:	PMB 426
City	:	DALLAS
State	:	TX
Zip	:	75230
Country	:	US
Telephone Number	:	972-587-7246
Fax Number	:	214-613-6979

Provider Business Practice Location Address
First Line	:	7557 RAMBLER RD STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2306
Country	:	US
Telephone Number	:	214-507-2831
Fax Number	:	214-507-2831

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	CURTIS LEE ADAMS
Credential	:	FNP
Telephone Number	:	972-587-7246

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	04/17/2018

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