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General NPI Number Information
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NPI Number | 1922645332
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Entity Type | Organization
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Legal Business Name | MOMENTUM REGENERATIVE MEDICINE PLLC
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 2770 FM 1463 RD STE 101B
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City | KATY
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State | TX
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Zip | 77494-7968
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Country | US
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Telephone | 346-257-4179
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Fax |
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Provider Business Mailing Address
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Address Line | 2770 FM 1463 RD STE 101B
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City | KATY
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State | TX
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Zip | 77494-7968
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Country | US
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Telephone | 346-257-4179
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN PAUL BARNWELL
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Credential |
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Telephone | 281-827-9716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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