Provider Demographics
NPI:1669485025
Name:STACHNIAK, REBECCA E (MD)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:E
Last Name:STACHNIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3060 COMMUNICATIONS PKWY
Mailing Address - Street 2:201
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8449
Mailing Address - Country:US
Mailing Address - Phone:972-943-9779
Mailing Address - Fax:972-943-9776
Practice Address - Street 1:3060 COMMUNICATIONS PKWY
Practice Address - Street 2:201
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8449
Practice Address - Country:US
Practice Address - Phone:972-943-9779
Practice Address - Fax:972-943-9776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIC-125029207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F4401Medicare PIN
TXG72508Medicare UPIN