Provider Demographics
NPI:1497948913
Name:BUTLER, REBECCA (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 MCMAKIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-8438
Mailing Address - Country:US
Mailing Address - Phone:940-455-7200
Mailing Address - Fax:940-455-7214
Practice Address - Street 1:74 MCMAKIN RD
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226-8438
Practice Address - Country:US
Practice Address - Phone:806-470-4684
Practice Address - Fax:469-464-5260
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics