MEDICARE: DR. REBEKAH SWICEGOOD OD

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	152W00000X	Optometrist	10748TG	TX

General Provider Information

NPI Number	:	1932814928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBEKAH SWICEGOOD OD

Provider Business Mailing Address
First Line	:	10411 NORTH FWY # 45
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77037-1124
Country	:	US
Telephone Number	:	832-546-0246
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 N MAIN ST STE A
Second Line	:
City	:	DAYTON
State	:	TX
Zip	:	77535-2635
Country	:	US
Telephone Number	:	936-258-0020
Fax Number	:	936-257-8111

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

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	08/30/2024

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