MEDICARE: PGR, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	1041C0700X	Clinical Social Worker
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1285947887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PGR, INC.

Provider Business Mailing Address
First Line	:	9639 HILLCROFT AVE.
Second Line	:	# 888
City	:	HOUSTON
State	:	TX
Zip	:	77096-3805
Country	:	US
Telephone Number	:	281-221-9992
Fax Number	:	281-884-6004

Provider Business Practice Location Address
First Line	:	9639 HILLCROFT AVE.
Second Line	:	# 888
City	:	HOUSTON
State	:	TX
Zip	:	77096-3805
Country	:	US
Telephone Number	:	281-221-9992
Fax Number	:	281-884-6004

Authorized Official
Title or Position	:	OWNER
Name	:	PERRY RICHKER
Credential	:	M.ED., LPC, LCDC
Telephone Number	:	281-221-9992

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	08/13/2010

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Directions to “PGR, INC. ” Practice Location

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