Provider Demographics
NPI:1992714554
Name:BAUMGARNER, REBEKAH J (MD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:J
Last Name:BAUMGARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2316
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-2316
Mailing Address - Country:US
Mailing Address - Phone:281-548-3627
Mailing Address - Fax:281-548-3660
Practice Address - Street 1:8901 FM 1960 BYPASS W.
Practice Address - Street 2:SUITE 201
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4025
Practice Address - Country:US
Practice Address - Phone:281-548-3627
Practice Address - Fax:281-548-3660
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89011GOtherBCBS PROVIDER NUMBER
TXJ3627OtherMEDICAL LICENSE NUMBER
TX045015701Medicaid
TX760559650OtherTAX IDENTIFICATION NUMBER
TX86841JMedicare ID - Type Unspecified
TX760559650OtherTAX IDENTIFICATION NUMBER