Provider Demographics
NPI:1982980223
Name:RENFRO, DEAN
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:
Last Name:RENFRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 WILLOW FOREST DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5417
Mailing Address - Country:US
Mailing Address - Phone:281-226-0867
Mailing Address - Fax:
Practice Address - Street 1:8102 WILLOW FOREST DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5417
Practice Address - Country:US
Practice Address - Phone:281-226-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications