Healthcare Provider Details

I. General information

NPI: 1194377267
Provider Name (Legal Business Name): REBECCA PRESTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15511 W HWY 71 STE 110
BEE CAVE TX
78738-2825
US

IV. Provider business mailing address

15511 W HWY 71 STE 110
BEE CAVE TX
78738-2825
US

V. Phone/Fax

Practice location:
  • Phone: 512-759-6338
  • Fax: 512-957-8537
Mailing address:
  • Phone: 512-759-6338
  • Fax: 512-957-8537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-90746
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: