Individual ProviderRebecca B LustgartenNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019(512) 454-2454PECOS EnrollmentBased on the most recent information from CMS, provider Rebecca B Lustgarten does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1144203597Provider TypeIndividualFull NameLustgarten, Rebecca BCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date11/21/2005Last Updated11/1/2007Contact InformationPractice LocationPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Mailing LocationMailing Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense37633TexasProvider IdentifiersIDDescriptionIssuerID80252CDescriptionOtherIssuerBC/BSTexasID88557601DescriptionMedicaidIssuerUnlistedTexas