Provider Demographics
NPI:1922662212
Name:RENAXIS, PLLC
Entity Type:Organization
Organization Name:RENAXIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TALAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:346-278-5330
Mailing Address - Street 1:4126 SOUTHWEST FWY STE 1220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7338
Mailing Address - Country:US
Mailing Address - Phone:346-388-3595
Mailing Address - Fax:833-857-0028
Practice Address - Street 1:4126 SOUTHWEST FWY STE 1220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7338
Practice Address - Country:US
Practice Address - Phone:346-278-5330
Practice Address - Fax:833-857-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty