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General NPI Number Information
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NPI Number | 1952114332
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Entity Type | Organization
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Legal Business Name | RENEW REHAB LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2351 W NORTHWEST HWY STE 3105
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City | DALLAS
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State | TX
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Zip | 75220-4453
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Country | US
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Telephone | 972-391-8903
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Fax | 972-391-8903
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Provider Business Mailing Address
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Address Line | 1325 EDGEWOOD CT
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City | CARROLLTON
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State | TX
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Zip | 75007-2766
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Country | US
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Telephone | 972-989-6396
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BECKY VALDEZ
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Credential |
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Telephone | 972-391-8903
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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 |
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