MEDICARE: DR. KENNETH THOMAS REGNER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC6752	TX

General Provider Information

NPI Number	:	1902832322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH THOMAS REGNER D.C.

Provider Business Mailing Address
First Line	:	7830 W GRAND PKWY S
Second Line	:	STE 180
City	:	RICHMOND
State	:	TX
Zip	:	77406-5819
Country	:	US
Telephone Number	:	832-222-2225
Fax Number	:	832-222-2199

Provider Business Practice Location Address
First Line	:	1145 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1021
Country	:	US
Telephone Number	:	281-493-2535
Fax Number	:	281-493-1855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	11/09/2016

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