Healthcare Provider Details

I. General information

NPI: 1891979167
Provider Name (Legal Business Name): RENAISSANCE HOSPITAL TERREL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 N 4TH ST
WILLS POINT TX
75169-1616
US

IV. Provider business mailing address

14440 JOHN F KENNEDY BLVD
HOUSTON TX
77032-5300
US

V. Phone/Fax

Practice location:
  • Phone: 903-873-6161
  • Fax:
Mailing address:
  • Phone: 832-886-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL SMESNY
Title or Position: PRESIDENT
Credential:
Phone: 832-886-1900