MEDICARE: REBECCA SUE RUNYAN DOWDY NP

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	363LW0102X	Women's Health Nurse Practitioner	AP115402	TX

General Provider Information

NPI Number	:	1336218981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SUE RUNYAN DOWDY NP

Provider Business Mailing Address
First Line	:	20414 VICTORIOUS DR
Second Line	:
City	:	HOCKLEY
State	:	TX
Zip	:	77447-8768
Country	:	US
Telephone Number	:	281-516-3158
Fax Number	:

Provider Business Practice Location Address
First Line	:	15003 FM 529 RD
Second Line	:	STE A
City	:	HOUSTON
State	:	TX
Zip	:	77095-4375
Country	:	US
Telephone Number	:	713-230-8677
Fax Number	:	281-345-7587

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	12/15/2016

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