Organization Active NPI

Regenerative Spine Pain & Wellness Institute PLLC

  • Pain Medicine Physician
  • Plano, TX
National Provider Identifier
1609355932
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
REGENERATIVE SPINE PAIN & WELLNESS INSTITUTE PLLC
Practice address
7709 San Jacinto PL Ste 101
Plano, TX 75024-3366
Phone
(214) 709-1904
Fax
(214) 279-8764
NPI assigned
Aug 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Flavio Calderon
Title
Director
Phone
(214) 709-1904

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

7709 San Jacinto PL Ste 101
Plano, TX 75024-3366

Mailing address

7709 San Jacinto PL Ste 101
Plano, TX 75024-3366
Phone (214) 709-1904

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1609355932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 SAN JACINTO PL STE 101",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243366",
            "telephone_number": "214-709-1904",
            "fax_number": "214-279-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 SAN JACINTO PL STE 101",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243366",
            "telephone_number": "214-709-1904",
            "fax_number": "214-279-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE SPINE PAIN & WELLNESS INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "FLAVIO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-709-1904"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.