Provider Demographics
NPI:1922645332
Name:MOMENTUM REGENERATIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:MOMENTUM REGENERATIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BARNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-827-9716
Mailing Address - Street 1:2770 FM 1463 RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7968
Mailing Address - Country:US
Mailing Address - Phone:346-257-4179
Mailing Address - Fax:
Practice Address - Street 1:2770 FM 1463 RD STE 101B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7968
Practice Address - Country:US
Practice Address - Phone:346-257-4179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty