Provider Demographics
NPI:1346235330
Name:ROURK, REBECCA (NPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ROURK
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7150 GREENVILLE AVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-7900
Mailing Address - Country:US
Mailing Address - Phone:214-369-3613
Mailing Address - Fax:214-706-2019
Practice Address - Street 1:7150 GREENVILLE AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7900
Practice Address - Country:US
Practice Address - Phone:469-916-7842
Practice Address - Fax:214-706-2019
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX666279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q42190Medicare UPIN
TX00QF54Medicare UPIN