Organization Active NPI

Regenerative & Restorative Rehab, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Bryan, TX
National Provider Identifier
1306454145
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REGENERATIVE & RESTORATIVE REHAB, PLLC
Practice address
1600 Joseph Dr Ste 1516
Bryan, TX 77802-1502
Phone
(817) 284-9850
Fax
(817) 284-9859
NPI assigned
Jul 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Lee
Title
Manager
Phone
(817) 284-9850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1600 Joseph Dr Ste 1516
Bryan, TX 77802-1502

Mailing address

PO Box 6442
Bryan, TX 77805-6442
Phone (817) 284-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200901000347 TX Part B Supplier - Clinic/Group Practice 4284051616 Receives reassigned benefits from 2 practitioners
Practice locations: Bryan, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1306454145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6442",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778056442",
            "telephone_number": "817-284-9850",
            "fax_number": "817-284-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 JOSEPH DR STE 1516",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778021502",
            "telephone_number": "817-284-9850",
            "fax_number": "817-284-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE & RESTORATIVE REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-17",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-284-9850"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.