Provider Demographics
NPI:1780691030
Name:REHBERG, ERIN M (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:REHBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:TINDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3721 GALENA HILLS LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1035
Mailing Address - Country:US
Mailing Address - Phone:512-740-5174
Mailing Address - Fax:
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-443-9355
Practice Address - Fax:512-443-3206
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04695363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1659349009OtherAEC GROUP NPI
TX8Y0263OtherBLUE CROSS PROVIDER NUMBE