Individual
DR. REBECCA LYNN WIATREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12201 RENFERT WAY, SUITE 240, AUSTIN, TX 78758-5354
(512) 498-4850
(512) 491-8387
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
M7757
TX
2086X0206X
Surgical Oncology Physician
Primary
M7757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302090105
—
TX
05
—
302090106
—
TX
01
—
P01626912
RAILROAD MEDICARE
TX
Enumeration date
07/09/2008
Last updated
05/09/2016
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