Provider Demographics
NPI:1932814928
Name:SWICEGOOD, REBEKAH (OD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:
Last Name:SWICEGOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 NORTH FWY # 45
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-1124
Mailing Address - Country:US
Mailing Address - Phone:832-546-0246
Mailing Address - Fax:
Practice Address - Street 1:306 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-2635
Practice Address - Country:US
Practice Address - Phone:936-258-0020
Practice Address - Fax:936-257-8111
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10748TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist