MEDICARE: PROGRESSIVE PHYSICAL THERAPY

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	261QP2000X	Physical Therapy Clinic/Center	106982	TX

General Provider Information

NPI Number	:	1811250012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	15211 PARK ROW
Second Line	:	223
City	:	HOUSTON
State	:	TX
Zip	:	77084-4137
Country	:	US
Telephone Number	:	832-419-3155
Fax Number	:	888-826-7916

Provider Business Practice Location Address
First Line	:	15211 PARK ROW
Second Line	:	223
City	:	HOUSTON
State	:	TX
Zip	:	77084-4137
Country	:	US
Telephone Number	:	832-419-3155
Fax Number	:	888-826-7916

Authorized Official
Title or Position	:	OWNER
Name	:	MISS LAURA MILENA GUARIN
Credential	:	PT
Telephone Number	:	832-419-3155

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	06/21/2012

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Directions to “PROGRESSIVE PHYSICAL THERAPY ” Practice Location

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