Provider Demographics
NPI:1386355659
Name:LIPE, REBECCA (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LIPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BECKEY
Other - Middle Name:
Other - Last Name:HAKES-LIPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:3502 154TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6314
Mailing Address - Country:US
Mailing Address - Phone:806-790-4406
Mailing Address - Fax:
Practice Address - Street 1:815 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LITTLEFIELD
Practice Address - State:TX
Practice Address - Zip Code:79339-3103
Practice Address - Country:US
Practice Address - Phone:806-385-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist