Provider Demographics
NPI:1083064059
Name:CHERIAN, REBEKAH (DPM)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MOREDUN RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4016
Mailing Address - Country:US
Mailing Address - Phone:214-505-1542
Mailing Address - Fax:
Practice Address - Street 1:1601 N BELT LINE RD STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1791
Practice Address - Country:US
Practice Address - Phone:972-288-7442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2387213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery