Provider Demographics
NPI:1619158037
Name:RENIASANCE HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:RENIASANCE HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON/CHUKWU
Authorized Official - Middle Name:O/L
Authorized Official - Last Name:NDUKWE/KALU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-785-2300
Mailing Address - Street 1:7111 HARWIN DR
Mailing Address - Street 2:SUITE NO 218
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2129
Mailing Address - Country:US
Mailing Address - Phone:832-785-2300
Mailing Address - Fax:713-972-3800
Practice Address - Street 1:7111 HARWIN DR
Practice Address - Street 2:SUITE NO 218
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2129
Practice Address - Country:US
Practice Address - Phone:832-785-2300
Practice Address - Fax:713-972-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies