TESTOSTERONE REJUVENATION AND MEDICAL SPA, INC (NPI# 1083107379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083107379 |
| Entity Type | Organization |
| Organization Name | TESTOSTERONE REJUVENATION AND MEDICAL SPA, INC |
| Practice Address |
430 Highway 6 S Ste 204 Houston TX 77079-2339 |
| Practice Telephone | 7136880752 |
| Practice Fax Number | 7136880842 |
| Mailing Telephone | 7136880752 |
| Mailing Fax Number | 7136880842 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-11 |
| Authorized Official Name | ENITAN BEAZER (CEO/ ADMIN) |
| Authorized Official Telephone | 7136880752 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Street Address |
430 HIGHWAY 6 S STE 204 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77079-2339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213542 | Apg Ancillaries LLC | Durable Medical Equipment & Medical Supplies | 14811 Saint Marys Ln Ste 152, Houston, TX 77079 | 2020-07-29 |
| 1982244174 | Agatha Nwosu | Registered Nurse | 1155 Dairy Ashford Rd Suite 560, Houston, TX 77079 | 2020-01-15 |
| 1164924650 | Victoria Okon | Licensed Vocational Nurse | 14461 Still Meadow Dr., Houston, TX 77079 | 2018-03-01 |
| 1649711623 | Deon Flenoy | Case Manager/Care Coordinator | 14027 Memorial Dr # 419, Houston, TX 77079 | 2017-03-10 |
| 1396298428 | Supriya Krishnan | Optometrist | 14634 Memorial Dr, Houston, TX 77079 | 2016-07-25 |
| 1942670401 | Medfast Pediatric & Family Clinic | Nurse Practitioner | 14520 Old Katy Rd, St 109, Houston, TX 77079 | 2015-09-28 |
| 1558742106 | Evan Christopher Adams | Dentist | 909 Dairy Ashford Rd Ste 104, Houston, TX 77079 | 2015-06-09 |
| 1114313152 | Yun Li | Internal Medicine | 13140 Trail Hollow Dr, Houston, TX 77079 | 2015-04-07 |
| 1629460308 | Michelle Maligaya | Registered Nurse | 1201 N Dairy Ashford Rd Ste 100, Houston, TX 77079 | 2015-03-04 |
| 1144611989 | Ryan M Keutzer | Hearing Instrument Specialist | 12900 Queensbury Ln #100, Houston, TX 77079 | 2015-02-16 |
| Find all providers in zip 77079 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1265063853 | Egolink Express Inc | Clinic/Center | 10333 Harwin Dr Ste 518, Houston, TX 77036-1561 | 2020-02-01 |
| 1588201172 | Ptsd Foundation of America | Clinic/Center | 9724 Derrington Rd, Houston, TX 77064-5808 | 2019-12-03 |
| 1841840915 | Christine C Gooch | Clinic/Center | 8145 Highway 6 S Ste 130, Houston, TX 77083-5740 | 2019-09-19 |
| 1437713328 | Vascmed LLC | Clinic/Center | 14441 Memorial Dr Ste 16, Houston, TX 77079-6737 | 2019-04-25 |
| 1467916940 | Rcb Funding Group LLC | Clinic/Center | 950 Threadneedle St # 295, Houston, TX 77079-2925 | 2019-01-29 |
| 1235629049 | Star Luxury Enterprises Inc | Clinic/Center | 10101 Bissonnet St Ste 101, Houston, TX 77036-7855 | 2018-05-16 |
| 1679096721 | Hope Adol Outpatient Txt Center for Mental and Behavior Health, LLC | Clinic/Center | 9006 Scott St, Houston, TX 77051-2751 | 2017-07-20 |
| 1710408448 | Ultimate Wellness Providers Co | Clinic/Center | 3203 Kelling Street, Houston, TX 77045 | 2017-07-03 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.