Healthcare Provider Details
I. General information
NPI: 1982800116
Provider Name (Legal Business Name): REBEKAH ELIZABETH SPERLING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 E WHITESTONE BLVD
CEDAR PARK TX
78613-9049
US
IV. Provider business mailing address
12201 RENFERT WAY SUITE #110
AUSTIN TX
78758-5354
US
V. Phone/Fax
- Phone: 512-259-0900
- Fax: 512-259-0949
- Phone: 512-491-5125
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | M6892 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: