Individual provider Active NPI

Rebecca Vasquez, SA-C

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1407155393
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10-248 Issued in TX
Practice address
12436 FM 1960 Rd W
Suite 171
Houston, TX 77065-4809
Phone
(281) 653-2924
Fax
(832) 478-9266
NPI assigned
Mar 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT009639 TX
Surgical Assistant 246ZC0007X 10-248 TX
Surgical Physician Assistant 363AS0400X 10-248 TX Primary

Addresses

Primary practice location

12436 FM 1960 Rd W
Suite 171
Houston, TX 77065-4809

Mailing address

12436 FM 1960 Rd W
Suite 171
Houston, TX 77065-4809
Phone (281) 653-2924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT009639TXMDMassage Therapist
10-248TXMDSurgical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1407155393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12436 FM 1960 RD W",
            "address_2": "SUITE 171",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654809",
            "telephone_number": "281-653-2924",
            "fax_number": "832-478-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12436 FM 1960 RD W",
            "address_2": "SUITE 171",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654809",
            "telephone_number": "281-653-2924",
            "fax_number": "832-478-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT009639",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "10-248",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "10-248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.