Provider Demographics
NPI:1477115996
Name:HOUSTON REGENERATIVE THERAPY LLC
Entity Type:Organization
Organization Name:HOUSTON REGENERATIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TON
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-777-7888
Mailing Address - Street 1:947 GESSNER RD STE A250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1730
Mailing Address - Country:US
Mailing Address - Phone:713-777-7888
Mailing Address - Fax:832-831-9061
Practice Address - Street 1:947 GESSNER RD STE A250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1730
Practice Address - Country:US
Practice Address - Phone:713-587-0900
Practice Address - Fax:832-831-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-04
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty