# RENAISSANCE HEALTH AND WELLNESS OF TEXAS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881082238
- **Authorized official:** CHESTER L CARLSON D.O. (MEDICAL DIRECTOR)
- **Authorized official phone:** (479) 434-4948

## Contact information

- **Practice address:** 17721 DALLAS PKWY, SUITE 116, DALLAS, TX 75287-7343
- **Practice address phone:** (214) 378-4700
- **Mailing address:** 17721 DALLAS PKWY, SUITE 116, DALLAS, TX 75287-7343
- **Mailing address phone:** (214) 378-4700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | Q2522 | TX | Yes |

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 01/07/2015