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General NPI Number Information
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NPI Number | 1053134338
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Entity Type | Organization
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Legal Business Name | REGEN RX PLLC
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 3501 S SONCY RD STE 1001
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City | AMARILLO
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State | TX
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Zip | 79119-4932
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Country | US
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Telephone | 806-367-8719
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Fax | 806-418-4329
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Provider Business Mailing Address
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Address Line | 3501 S SONCY RD STE 1001
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City | AMARILLO
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State | TX
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Zip | 79119-4932
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Country | US
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Telephone | 806-367-8719
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTICING DOCTOR
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Name | KEITH DYER
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Credential | MD
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Telephone | 806-367-8719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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