Provider Demographics
NPI:1407301435
Name:PROGRESSIVE HEALTH DIAGNOSTICS
Entity Type:Organization
Organization Name:PROGRESSIVE HEALTH DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-296-2011
Mailing Address - Street 1:5550 LYNDON B JOHNSON FWY
Mailing Address - Street 2:190
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6217
Mailing Address - Country:US
Mailing Address - Phone:800-974-8699
Mailing Address - Fax:972-204-5792
Practice Address - Street 1:1505 HARROUN AVE # 2
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3432
Practice Address - Country:US
Practice Address - Phone:800-974-8699
Practice Address - Fax:972-204-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory