Provider Demographics
NPI:1598264160
Name:STAUDT, REBECCA (OTR)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STAUDT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 BEE CAVE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6135
Mailing Address - Country:US
Mailing Address - Phone:512-306-8007
Mailing Address - Fax:512-672-6178
Practice Address - Street 1:5000 BEE CAVES RD STE 206
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5552
Practice Address - Country:US
Practice Address - Phone:512-284-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist