Provider Demographics
NPI:1962590976
Name:HUFFMAN, REBEL RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:REBEL
Middle Name:RENEE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REBEL
Other - Middle Name:R
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 130189
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-0189
Mailing Address - Country:US
Mailing Address - Phone:903-939-7500
Mailing Address - Fax:903-939-7728
Practice Address - Street 1:3414 GOLDEN RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8336
Practice Address - Country:US
Practice Address - Phone:903-939-7500
Practice Address - Fax:903-939-7728
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN57352086S0105X, 207XS0106X
OK26941207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand