Provider Demographics
NPI:1811204357
Name:PROGRESSIVE HEALTH FAMILY MEDICINE
Entity Type:Organization
Organization Name:PROGRESSIVE HEALTH FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARIDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-719-6553
Mailing Address - Street 1:8901 VIRGINIA PKWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5701
Mailing Address - Country:US
Mailing Address - Phone:972-369-1871
Mailing Address - Fax:972-369-1872
Practice Address - Street 1:8901 VIRGINIA PKWY
Practice Address - Street 2:SUITE 700
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5701
Practice Address - Country:US
Practice Address - Phone:972-369-1871
Practice Address - Fax:972-369-1872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7246207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty