Provider Demographics
NPI:1306525217
Name:RENEWED AND EMPOWERED PLLC
Entity type:Organization
Organization Name:RENEWED AND EMPOWERED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:VI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-S
Authorized Official - Phone:945-386-9605
Mailing Address - Street 1:120 E FM 544 STE 72-274
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4034
Mailing Address - Country:US
Mailing Address - Phone:945-386-9605
Mailing Address - Fax:
Practice Address - Street 1:120 E FM 544 STE 72-274
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4034
Practice Address - Country:US
Practice Address - Phone:945-386-9605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)