Provider Demographics
NPI:1225479959
Name:PRO HEALTHCARE LLC
Entity Type:Organization
Organization Name:PRO HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT CLINICAL NURSE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:FURQAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:972-584-7616
Mailing Address - Street 1:820 S MACARTHUR BLVD
Mailing Address - Street 2:SUITE#105-281
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4216
Mailing Address - Country:US
Mailing Address - Phone:972-584-7616
Mailing Address - Fax:214-853-5364
Practice Address - Street 1:1420 VALWOOD PKWY
Practice Address - Street 2:SUITE NO. 20-170A
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-8312
Practice Address - Country:US
Practice Address - Phone:972-584-7616
Practice Address - Fax:214-853-5364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1483207R00000X
TX696580364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty