Provider Demographics
NPI:1598092280
Name:PROGRESSIVE MEDICINE ASSOCIATES, LLC.
Entity Type:Organization
Organization Name:PROGRESSIVE MEDICINE ASSOCIATES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:AHADI
Authorized Official - Last Name:AKHLAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:713-978-6337
Mailing Address - Street 1:8811 WESTHEIMER RD
Mailing Address - Street 2:101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3626
Mailing Address - Country:US
Mailing Address - Phone:713-978-6337
Mailing Address - Fax:713-532-6337
Practice Address - Street 1:8811 WESTHEIMER RD
Practice Address - Street 2:101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3626
Practice Address - Country:US
Practice Address - Phone:713-978-6337
Practice Address - Fax:713-532-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05456261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care