NPIMap

Organization Active NPI

Rejuvenation Pharmacy Incorporated LLC

  • Specialty Pharmacy
  • Hurst, TX
National Provider Identifier
1417870072
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
REJUVENATION PHARMACY INCORPORATED LLC
Practice address
1550 Norwood Dr Ste 300
Hurst, TX 76054-3653
Phone
(281) 336-9927
Fax
(281) 335-6645
NPI assigned
Jul 31, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
REJUVENATION PHARMACY INCORPORATED LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Dr. Christopher Vard Tyrone II, PHARMD
Title
Chief Pharmacy Officer
Phone
(682) 438-2904

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X Primary

Addresses

Primary practice location

1550 Norwood Dr Ste 300
Hurst, TX 76054-3653

Mailing address

1550 Norwood Dr Ste 300
Hurst, TX 76054-3653
Phone (281) 336-9927

National Provider Directory

National Provider Directory
Tax ID family
Rejuvenation Pharmacy Incorporated LLC2 organizations share this tax ID, including this one
Part of
Rejuvenation Pharmacy Incorporated LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1550 Norwood Dr
Ste 300
Hurst, TX 76054
Phone (281) 336-9927

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1417870072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 NORWOOD DR STE 300",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543653",
            "telephone_number": "281-336-9927",
            "fax_number": "281-335-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NORWOOD DR STE 300",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543653",
            "telephone_number": "281-336-9927",
            "fax_number": "281-335-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION PHARMACY INCORPORATED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REJUVENATION PHARMACY INCORPORATED LLC",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "TYRONE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "VARD",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "682-438-2904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.