Provider Demographics
NPI:1568439016
Name:SCHWANECKE, REBECCA PINEDA (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:PINEDA
Last Name:SCHWANECKE
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 1:4151 SOUTHWEST FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7324
Mailing Address - Country:US
Mailing Address - Phone:713-771-3572
Mailing Address - Fax:713-981-1611
Practice Address - Street 1:4151 SOUTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7324
Practice Address - Country:US
Practice Address - Phone:713-771-3572
Practice Address - Fax:713-981-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD77872080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132959105Medicaid
TX00L962OtherBLUE CROSS BLUE SHIELD