Provider Demographics
NPI:1053134338
Name:REGEN RX PLLC
Entity type:Organization
Organization Name:REGEN RX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTICING DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-367-8719
Mailing Address - Street 1:3501 S SONCY RD STE 1001
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-4932
Mailing Address - Country:US
Mailing Address - Phone:806-367-8719
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD STE 1001
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-4932
Practice Address - Country:US
Practice Address - Phone:806-367-8719
Practice Address - Fax:806-418-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty