Provider Demographics
NPI:1962172882
Name:GENTLE, RENEE (DC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:GENTLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7324 SOUTHWEST FWY STE 1045
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2090
Mailing Address - Country:US
Mailing Address - Phone:346-235-8491
Mailing Address - Fax:833-909-2108
Practice Address - Street 1:7324 SOUTHWEST FWY STE 1045
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2090
Practice Address - Country:US
Practice Address - Phone:346-235-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor