MEDICARE: ELIZABETH REBELLO M.D.

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	207L00000X	Anesthesiology Physician	L8913	TX

General Provider Information

NPI Number	:	1124038765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH REBELLO M.D.

Provider Business Mailing Address
First Line	:	1400 HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4008
Country	:	US
Telephone Number	:	713-563-9332
Fax Number	:	713-792-7656

Provider Business Practice Location Address
First Line	:	1400 HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4008
Country	:	US
Telephone Number	:	713-563-9332
Fax Number	:	713-792-7656

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	10/03/2007

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