Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G8872 | TX |
NPI | 1013024173 |
---|---|
Provider Name | Dr. Rebecca Lea Huston |
First Address | San Antonio, TX 78207-3100 |
Second Address | San Antonio, TX 78207-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
111828308 | (05) | TX |