MEDICARE: REBECCA DANIEL PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	214737	OK
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1232102	TX

General Provider Information

NPI Number	:	1447933056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA DANIEL PMHNP

Provider Business Mailing Address
First Line	:	1507 LYNDON B JOHNSON FWY STE 750
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-6088
Country	:	US
Telephone Number	:	817-527-8621
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 LYNDON B JOHNSON FWY STE 750
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-6088
Country	:	US
Telephone Number	:	817-527-8621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	04/23/2026

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