Provider Demographics
NPI:1629499892
Name:DEARMAN, RENA (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:DEARMAN
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25301 BOROUGH PARK DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3560
Mailing Address - Country:US
Mailing Address - Phone:979-373-8084
Mailing Address - Fax:
Practice Address - Street 1:25301 BOROUGH PARK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3560
Practice Address - Country:US
Practice Address - Phone:979-373-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT113332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist