Provider Demographics
NPI:1083007728
Name:PROGRESSIVE INTEGRATED HEALTHCARE LLC
Entity type:Organization
Organization Name:PROGRESSIVE INTEGRATED HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:972-587-7246
Mailing Address - Street 1:11700 PRESTON RD STE 660
Mailing Address - Street 2:PMB 426
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:972-587-7246
Mailing Address - Fax:214-613-6979
Practice Address - Street 1:7557 RAMBLER RD STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2306
Practice Address - Country:US
Practice Address - Phone:214-507-2831
Practice Address - Fax:214-507-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1124457213Medicaid