Provider Demographics
NPI:1639655806
Name:THE REGENERATIVE INSTITUTE OF TEXAS
Entity Type:Organization
Organization Name:THE REGENERATIVE INSTITUTE OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-323-9404
Mailing Address - Street 1:PO BOX 50689
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206
Mailing Address - Country:US
Mailing Address - Phone:940-323-9404
Mailing Address - Fax:940-323-9422
Practice Address - Street 1:3716 STANDRIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056
Practice Address - Country:US
Practice Address - Phone:940-323-9404
Practice Address - Fax:940-323-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2060208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32043761744OtherTTN