Provider Demographics
NPI:1952114332
Name:RENEW REHAB LLC
Entity type:Organization
Organization Name:RENEW REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-391-8903
Mailing Address - Street 1:1325 EDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2766
Mailing Address - Country:US
Mailing Address - Phone:972-989-6396
Mailing Address - Fax:
Practice Address - Street 1:2351 W NORTHWEST HWY STE 3105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4453
Practice Address - Country:US
Practice Address - Phone:972-391-8903
Practice Address - Fax:972-391-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty