Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 1255 | NE |
Y | 207Q00000X | Family Doctor | T1515 | TX |
N | 207QS0010X | Family Doctor - Sports Medicine | 1255 | NE |
N | 207QS0010X | Family Doctor - Sports Medicine | T1515 | TX |
NPI | 1245678457 |
---|---|
Provider Name | Dr. Rebecca L Peebles |
First Address | Tyler, TX 75708-3154 |
Second Address | Tyler, TX 75701-6606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 18/05/2021 |