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Renew Medical Spa Llc
Medical Specialty Clinic/Center in Texarkana, Texas
NPI 1164739025

Renew Medical Spa Llc is a Medical Specialty Clinic/Center based in Texarkana, TX and is specialized in Medical Specialty. Renew Medical Spa Llc practices in Texarkana, TX. The NPI Number for Renew Medical Spa Llc is 1164739025 and holds a License No. PA00892 (Texas).

The current practice location address for Renew Medical Spa Llc is 3939 Texas Blvd, Texarkana, TX and can be reached out via phone at 903-255-6398 and via fax at 903-794-6304.

Location: 3939 Texas Blvd, Texarkana, TX, 75503-3207
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164739025
Provider Name
Renew Medical Spa Llc
Credential
Provider Entity Type
Organization
Address
3939 Texas Blvd, Texarkana, TX, 75503-3207
Phone Number
903-255-6398
Fax Number
903-794-6304
Provider Enumeration Date
09/13/2010
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4995690001 01 TX CIGNA GOVERMENT SERVICES
institution
Provider Business Practice Location Address Details
Address
3939 Texas Blvd
City
Texarkana
State
Texas
Zip
75503-3207
Phone Number
903-255-6398
Fax Number
903-794-6304
person
Provider Business Mailing Address Details
Address
3939 Texas Blvd
City
Texarkana
State
Texas
Zip
75503-3207
Phone Number
903-255-6398
Fax Number
903-794-6304
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
PA00892 (Texas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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