Provider Demographics
NPI:1669007019
Name:TEXAS REGEN PLLC
Entity Type:Organization
Organization Name:TEXAS REGEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-993-2003
Mailing Address - Street 1:1819 E BROADWAY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5671
Mailing Address - Country:US
Mailing Address - Phone:281-993-2003
Mailing Address - Fax:877-781-6179
Practice Address - Street 1:1819 E BROADWAY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5671
Practice Address - Country:US
Practice Address - Phone:281-993-2003
Practice Address - Fax:877-781-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty