Provider Demographics
NPI:1265791172
Name:STALTER, REBEKAH (MD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:
Last Name:STALTER
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 1:3305 81ST ST STE H
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2028
Mailing Address - Country:US
Mailing Address - Phone:903-291-6290
Mailing Address - Fax:714-733-1235
Practice Address - Street 1:3305 81ST ST STE H
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2028
Practice Address - Country:US
Practice Address - Phone:903-291-6290
Practice Address - Fax:714-733-1235
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ72852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry