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Organization
RENAISSANCE HEALTH AND WELLNESS OF TEXAS, P.A.
Active
Organization
RENAISSANCE HEALTH AND WELLNESS OF TEXAS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHESTER L CARLSON D.O. (MEDICAL DIRECTOR)
(479) 434-4948
Entity
Organization
Contact information
Practice address
17721 DALLAS PKWY, SUITE 116, DALLAS, TX 75287-7343
(214) 378-4700
Mailing address
17721 DALLAS PKWY, SUITE 116, DALLAS, TX 75287-7343
(214) 378-4700
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
Q2522
TX
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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