Provider Demographics
NPI:1144560731
Name:TIBBITS, REBECCA CAMILLE (DC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:CAMILLE
Last Name:TIBBITS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 UPTOWN BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3512
Mailing Address - Country:US
Mailing Address - Phone:469-454-5100
Mailing Address - Fax:
Practice Address - Street 1:613 UPTOWN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3512
Practice Address - Country:US
Practice Address - Phone:469-454-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor