Provider Demographics
NPI:1093789729
Name:WATSON, REBECCA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNN
Last Name:WATSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7330 SAN PEDRO
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6235
Mailing Address - Country:US
Mailing Address - Phone:210-344-2673
Mailing Address - Fax:210-344-2649
Practice Address - Street 1:7330 SAN PEDRO
Practice Address - Street 2:SUITE 405
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6235
Practice Address - Country:US
Practice Address - Phone:210-344-2673
Practice Address - Fax:210-344-2649
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4830207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1119703-01Medicaid
TXH17627Medicare UPIN
TX00657LMedicare PIN