Provider Demographics
NPI:1750028700
Name:WHITFIELD, REBECCA MARIA (CSFA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MARIA
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE
Mailing Address - Street 2:SUITE B216
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6810
Mailing Address - Country:US
Mailing Address - Phone:214-613-1589
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE B216
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6810
Practice Address - Country:US
Practice Address - Phone:214-613-1589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
209577246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26023397OtherDRIVER LICENCSE