Provider Demographics
NPI:1215726138
Name:RENASCENT VENTURES LLC
Entity type:Organization
Organization Name:RENASCENT VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANYADIKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:346-716-0908
Mailing Address - Street 1:1111 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-9227
Mailing Address - Country:US
Mailing Address - Phone:346-716-0908
Mailing Address - Fax:
Practice Address - Street 1:1111 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435-9227
Practice Address - Country:US
Practice Address - Phone:346-716-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center