Provider Demographics
NPI:1902832322
Name:REGNER, KENNETH THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:THOMAS
Last Name:REGNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7830 W GRAND PKWY S
Mailing Address - Street 2:STE 180
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-5819
Mailing Address - Country:US
Mailing Address - Phone:832-222-2225
Mailing Address - Fax:832-222-2199
Practice Address - Street 1:1145 HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1021
Practice Address - Country:US
Practice Address - Phone:281-493-2535
Practice Address - Fax:281-493-1855
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6752111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU59080Medicare UPIN
TX86Y050Medicare PIN