Healthcare Provider Details

I. General information

NPI: 1477575991
Provider Name (Legal Business Name): REBECCA JANE SCOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CARE CIR
AMARILLO TX
79124-2105
US

IV. Provider business mailing address

17 CARE CIR
AMARILLO TX
79124-2105
US

V. Phone/Fax

Practice location:
  • Phone: 806-468-6277
  • Fax: 806-468-7174
Mailing address:
  • Phone: 806-468-6277
  • Fax: 806-468-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM0906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: