RENEW MEDICAL SPA AND NUTRITIONAL WELLNESS CENTER
NPI 1164739025
Clinic/Center - Medical Specialty in Texarkana, TX

Q: What is Renew Medical Spa LLC's NPI number?

The NPI number for Renew Medical Spa LLC is 1164739025. It was assigned to this organization in the NPPES registry on September 13, 2010. The provider is also known as Renew Medical Spa And Nutritional Wellness Center.

Q: What is Renew Medical Spa LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since September 13, 2010

3939 TEXAS BLVD, TEXARKANA, TX 75503(903) 255-6398(903) 794-6304 Get Directions Write a Review

NPPES record last updated: February 6, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Renew Medical Spa And Nutritional Wellness Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENEW MEDICAL SPA AND NUTRITIONAL WELLNESS CENTER (NPI 1164739025) is a healthcare organization registered as a medical specialty in Texarkana, Texas and active in the NPI registry since September 2010. The organization lists Theresa M Fontenot, Owner, as its authorized official.

NPPES Registry Identity

NPI1164739025

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameRENEW MEDICAL SPA LLC

Location Address3939 TEXAS BLVDTexarkana, TX 75503-3207

Mailing Address3939 Texas BlvdTexarkana, TX 75503-3207 · (903) 255-6398 · Fax (903) 794-6304

Phone(903) 255-6398

Fax(903) 794-6304

Organization SubpartNo

Authorized OfficialTheresa M FontenotOwner · (903) 255-6398

Enumeration DateSeptember 13, 2010

Last NPPES UpdateFebruary 6, 2012

✔ NPI 1164739025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

Licenses✔ Licensed in TX · PA00892✔ Licensed in AR · PA-190

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

3939 TEXAS BLVD, Texarkana, TX 75503

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Other Names 1

Other NameRenew Medical Spa And Nutritional Wellness Center

Other Identifiers 3

Medicare UPINR64719

Other4995690001TX · Cigna Goverment Services

Medicare PIN8B4007

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENEW WELLNESS SERVICES PLLC

Clinic/Center (Primary Care)

3939 TEXAS BLVD
TEXARKANA, TX 75503

Bowie County (903) 255-6398

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renew Medical Spa LLC's NPI number?

The NPI number for Renew Medical Spa LLC is 1164739025. It was assigned to this organization in the NPPES registry on September 13, 2010. The provider is also known as Renew Medical Spa And Nutritional Wellness Center.

Where is Renew Medical Spa LLC located?

Renew Medical Spa LLC is located at 3939 Texas Blvd, Texarkana, TX 75503. The listed phone number is (903) 255-6398.

What is Renew Medical Spa LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Renew Medical Spa LLC was last updated on February 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.