Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Renew Medical Spa LLC

Organization Medical Specialty Clinic/Center · NPI 1164739025

Renew Medical Spa LLC is a Medical Specialty Clinic/Center in Texarkana, Texas. Licensed in Arkansas and Texas. Registered with an NPI since 2010.

Licensed in
AR, TX
In the registry since
2010
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3939 Texas Blvd
Texarkana, TX 75503-3207
Phone: (903) 255-6398
Fax: (903) 794-6304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence PA00892 (TX)
Medical Specialty Clinic/Center Taxonomy 261QM2500X · Licence PA-190 (AR)

Record details

NPI number1164739025
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Fontenot — Owner · (903) 255-6398
Other names Renew Medical Spa And Nutritional Wellness Center
NPI enumeratedSeptember 13, 2010
Last updated in NPPESFebruary 6, 2012
Mailing address3939 Texas Blvd, Texarkana, TX 75503-3207

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