Organization
RENEW HYDRATION LLC
Active
Other names
Renew Hydration
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GONZALEZ (CEO)
(214) 837-8893
Entity
Organization
Contact information
Practice address
2601 W MOCKINGBIRD LN STE 100, DALLAS, TX 75235-5630
(469) 917-9166
(214) 951-9720
Mailing address
2601 W MOCKINGBIRD LN STE 100, DALLAS, TX 75235-5630
(469) 917-9166
(214) 951-9720
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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