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General NPI Number Information
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NPI Number | 1306454145
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Entity Type | Organization
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Legal Business Name | REGENERATIVE & RESTORATIVE REHAB, PLLC
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1600 JOSEPH DR STE 1516
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City | BRYAN
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State | TX
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Zip | 77802-1502
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Country | US
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Telephone | 817-284-9850
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Fax | 817-284-9859
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Provider Business Mailing Address
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Address Line | PO BOX 6442
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City | BRYAN
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State | TX
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Zip | 77805-6442
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Country | US
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Telephone | 817-284-9850
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Fax | 817-284-9859
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Authorized Official
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Title or Position | MANAGER
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Name | LISA LEE
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Credential |
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Telephone | 817-284-9850
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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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