Provider Demographics
NPI:1124561337
Name:PROGRESSIVE PAIN AND REHABILITATION LLC
Entity Type:Organization
Organization Name:PROGRESSIVE PAIN AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:346-220-8063
Mailing Address - Street 1:3281 COLLEGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4501
Mailing Address - Country:US
Mailing Address - Phone:346-220-8063
Mailing Address - Fax:832-838-4362
Practice Address - Street 1:3281 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4501
Practice Address - Country:US
Practice Address - Phone:346-220-8063
Practice Address - Fax:832-838-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty