Provider Demographics
NPI:1932542776
Name:SHORT, REBECCA ANN (MD)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:SHORT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3417 GASTON AVE STE 980
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2022
Mailing Address - Country:US
Mailing Address - Phone:469-800-8020
Mailing Address - Fax:469-800-8030
Practice Address - Street 1:3417 GASTON AVE STE 980
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2022
Practice Address - Country:US
Practice Address - Phone:469-800-8020
Practice Address - Fax:469-800-8030
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2023-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OR1932542776207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism