Provider Demographics
NPI:1497111843
Name:RESTORE & RELIEVE, PLLC
Entity Type:Organization
Organization Name:RESTORE & RELIEVE, PLLC
Other - Org Name:TEXAS RESTORE & RELIEVE, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:SHELTON
Authorized Official - Last Name:NESMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-859-2577
Mailing Address - Street 1:6031 EAST MAIN STREET
Mailing Address - Street 2:#318
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3590
Mailing Address - Country:US
Mailing Address - Phone:469-859-2577
Mailing Address - Fax:
Practice Address - Street 1:7200 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1703
Practice Address - Country:US
Practice Address - Phone:469-859-2577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4597208100000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty