1093028573 NPI number — PGR, INC

Table of content: (NPI 1093028573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093028573 NPI number — PGR, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PGR, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PROPSYCH TESTING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093028573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9639 HILLCROFT AVENUE
Provider Second Line Business Mailing Address:
888
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77096-3805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-221-9992
Provider Business Mailing Address Fax Number:
281-884-6004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9639 HILLCROFT AVENUE
Provider Second Line Business Practice Location Address:
888
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77096-3805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-221-9992
Provider Business Practice Location Address Fax Number:
281-884-6004
Provider Enumeration Date:
07/26/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RICHKER
Authorized Official First Name:
PERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-221-9992

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)