Provider Demographics
NPI:1003326570
Name:BUHL, REBEKAH GRACE
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:GRACE
Last Name:BUHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 NORTH O'CONNOR RD
Mailing Address - Street 2:APT #2077
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:972-689-1283
Mailing Address - Fax:
Practice Address - Street 1:2400 W I 20
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1670
Practice Address - Country:US
Practice Address - Phone:817-465-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX833304163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse