Provider Demographics
NPI:1659653764
Name:KENNETH THOMAS REGNER,D.C.,P.A.
Entity Type:Organization
Organization Name:KENNETH THOMAS REGNER,D.C.,P.A.
Other - Org Name:GRAND PARKWAY CHIROPRACTIC AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:REGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-799-7180
Mailing Address - Street 1:7830 W GRAND PKWY S
Mailing Address - Street 2:180
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-5816
Mailing Address - Country:US
Mailing Address - Phone:281-799-7180
Mailing Address - Fax:281-829-5230
Practice Address - Street 1:7830 W GRAND PKWY S
Practice Address - Street 2:180
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5816
Practice Address - Country:US
Practice Address - Phone:281-799-7180
Practice Address - Fax:281-829-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty