Healthcare Provider Details

I. General information

NPI: 1962590976
Provider Name (Legal Business Name): REBEL RENEE HUFFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEL R. HUFFMAN MD

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3414 GOLDEN RD
TYLER TX
75701-8336
US

IV. Provider business mailing address

4700 SETON CENTER PKWY STE 115
AUSTIN TX
78759-5753
US

V. Phone/Fax

Practice location:
  • Phone: 903-939-7500
  • Fax: 903-939-7728
Mailing address:
  • Phone: 346-440-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberN5735
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberN5735
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: