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Organization

REGENERATE ATX PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUSTIN N HOGAN MD (OWNER)
(512) 284-7025
Entity
Organization

Contact information

Practice address
11610 FM 2244 RD STE 230, AUSTIN, TX 78738-5457
(512) 284-7025
Mailing address
11610 FM 2244 RD STE 230, AUSTIN, TX 78738-5457
(512) 284-7025

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2083S0010X
Sports Medicine (Preventive Medicine) Physician

Other

Enumeration date
07/28/2020
Last updated
08/01/2020
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