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General NPI Number Information
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NPI Number | 1235923582
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Entity Type | Organization
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Legal Business Name | REJUVENATE IV PLLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1400 N COIT RD STE 302
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City | MCKINNEY
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State | TX
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Zip | 75071-6656
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Country | US
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Telephone | 469-473-2314
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Fax | 469-645-0492
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Provider Business Mailing Address
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Address Line | 1400 N COIT RD STE 302
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City | MCKINNEY
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State | TX
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Zip | 75071-6656
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Country | US
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Telephone | 469-473-2314
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | AHMED EMBABI
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Credential | MD
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Telephone | 469-831-8864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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