Healthcare Provider Details

I. General information

NPI: 1912837162
Provider Name (Legal Business Name): REGINE BAZIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 STATE HIGHWAY 121 STE 930
FRISCO TX
75035-9347
US

IV. Provider business mailing address

11500 STATE HIGHWAY 121 STE 930
FRISCO TX
75035-9347
US

V. Phone/Fax

Practice location:
  • Phone: 469-200-4093
  • Fax: 469-200-4079
Mailing address:
  • Phone: 469-200-4093
  • Fax: 469-200-4079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96701
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: