Sorc Regrowth | |
11811 North Fwy Ste 100 Houston TX 77060-3244 | |
(419) 378-9212 | |
Not Available |
Full Name | Sorc Regrowth |
---|---|
Speciality | Case Management |
Location | 11811 North Fwy Ste 100, Houston, Texas |
Authorized Official Name and Position | Tryna Smoot (OWNER/EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4193789212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Sorc Regrowth 723 Phillips Ave Bldg E Toledo OH 43612-1351 Ph: (419) 407-5981 | Sorc Regrowth 11811 North Fwy Ste 100 Houston TX 77060-3244 Ph: (419) 378-9212 |
NPI Number | 1033536255 |
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Provider Enumeration Date | 03/26/2014 |
Last Update Date | 01/16/2022 |
Certification Date | 01/16/2022 |
Medicare PECOS PAC ID | 6709217250 |
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Medicare Enrollment ID | O20200516000011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033536255 | NPI | - | NPPES |
1134667538 | Medicaid | OH | |
1134667538 | Medicaid | MI | |
1396076543 | Medicaid | TX | |
4226219 | Medicaid | TX | |
4234783 | Medicaid | TX | |
1134667538 | Medicaid | TX | |
1033536255 | Medicaid | TX | |
1063629608 | Medicaid | OH | |
1063629608 | Medicaid | MI |
Provider Name | Chuka D Onyeneke |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629104831 PECOS PAC ID: 8921061169 Enrollment ID: I20041116000009 |
Provider Name | Rebecca R Schlachet |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1063629608 PECOS PAC ID: 2567549892 Enrollment ID: I20080410000260 |
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