Individual provider Active NPI

Christian J. Renna, DO

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1508806738
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
F4442 Issued in TX
Practice address
2706 Fairmount St
Dallas, TX 75201-1958
Phone
(214) 303-1888
Fax
(214) 303-1550
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X F4442 TX Primary
General Practice Physician 208D00000X 20A6324 CA

Addresses

Primary practice location

2706 Fairmount St
Dallas, TX 75201-1958

Mailing address

2706 Fairmount St
Dallas, TX 75201-1958
Phone (214) 303-1888

Other identifiers 1

IdentifierTypeStateIssuer
8G3511OtherTXBLUE CROSS GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 10, 2024 through May 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A6324CAMDGeneral Practice Physician
F4442TXMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1508806738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 FAIRMOUNT ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011958",
            "telephone_number": "214-303-1888",
            "fax_number": "214-303-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 FAIRMOUNT ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011958",
            "telephone_number": "214-303-1888",
            "fax_number": "214-303-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNA",
        "first_name": "CHRISTIAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "F4442",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A6324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "8G3511",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.