Provider Demographics
NPI:1336329903
Name:VERELLEN, REBECCA M (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:M
Last Name:VERELLEN
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 1:601 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1103
Mailing Address - Country:US
Mailing Address - Phone:512-708-9200
Mailing Address - Fax:512-532-6261
Practice Address - Street 1:601 W 17TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1103
Practice Address - Country:US
Practice Address - Phone:512-708-9200
Practice Address - Fax:512-532-6261
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP40012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology