Provider Demographics
NPI:1609641240
Name:CENTER FOR APHERESIS AND REGENERATIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:CENTER FOR APHERESIS AND REGENERATIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:IPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-689-5139
Mailing Address - Street 1:15300 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-2004
Mailing Address - Country:US
Mailing Address - Phone:817-689-5139
Mailing Address - Fax:
Practice Address - Street 1:15300 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-2004
Practice Address - Country:US
Practice Address - Phone:817-689-5139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion MedicineGroup - Multi-Specialty
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical PathologyGroup - Multi-Specialty