Provider Demographics
NPI:1851421937
Name:REBMANN, TOBIAS P (ACNP)
Entity Type:Individual
Prefix:MR
First Name:TOBIAS
Middle Name:P
Last Name:REBMANN
Suffix:
Gender:M
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-606-6400
Mailing Address - Fax:
Practice Address - Street 1:1783 TROUP HWY
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:903-595-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP114600363L00000X, 363LA2100X
TX646065363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218896302Medicaid
TX455720165OtherTRICARE
TXP01844399OtherRAIL ROAD MEDICARE
TX8GW350OtherBCBS
TX218896301Medicaid
TX833N80OtherBCBS
TXTIN PLUS 042OtherTRICARE TMF HEART HOSPITAL LOCATION
TX574221ZHRKOtherMEDICARE
TXTIN PLUS 108OtherTRICARE
TX455720165OtherTRICARE
TX218896302Medicaid