Regenesys Physical Medicine Pllc | |
425 Old Newman Rd Ste 100 Frisco TX 75036-4773 | |
(972) 712-5556 | |
(972) 712-5579 |
Full Name | Regenesys Physical Medicine Pllc |
---|---|
Speciality | Family Medicine |
Location | 425 Old Newman Rd Ste 100, Frisco, Texas |
Authorized Official Name and Position | Brandon B Wilson (OWNER) |
Authorized Official Contact | 9727125556 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Regenesys Physical Medicine Pllc 425 Old Newman Rd Ste 100 Frisco TX 75036-4773 Ph: (972) 712-5556 | Regenesys Physical Medicine Pllc 425 Old Newman Rd Ste 100 Frisco TX 75036-4773 Ph: (972) 712-5556 |
NPI Number | 1518467059 |
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Provider Enumeration Date | 02/20/2018 |
Last Update Date | 01/03/2019 |
Medicare PECOS PAC ID | 7911268917 |
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Medicare Enrollment ID | O20180308002052 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518467059 | NPI | - | NPPES |
10828 | Other | TX | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Texas) | Primary |
Provider Name | Brandon B Wilson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1881862605 PECOS PAC ID: 8820158231 Enrollment ID: I20081114000528 |
Provider Name | Douglas K Mcclellan |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1962832311 PECOS PAC ID: 7719106673 Enrollment ID: I20140909000660 |
Provider Name | Scott E Hastings |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1174597553 PECOS PAC ID: 9436053147 Enrollment ID: I20141215000574 |
Provider Name | Erin E Hollis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518353523 PECOS PAC ID: 5597061416 Enrollment ID: I20160302002075 |
Provider Name | Marci Loree Lowe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295995827 PECOS PAC ID: 9032278049 Enrollment ID: I20180907000116 |
Provider Name | Christine Kratch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891316030 PECOS PAC ID: 8820415078 Enrollment ID: I20200918001953 |
Provider Name | Lauryn Gabrielle Pitts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316521669 PECOS PAC ID: 2769883156 Enrollment ID: I20210623000443 |
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