MEDICARE: RACHEL GERKE MA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	107711	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14063645	OTHER	TX	ASHA

General Provider Information

NPI Number	:	1609207562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL GERKE MA CCC-SLP

Provider Business Mailing Address
First Line	:	1000 HIGHLAND ST
Second Line	:	APT #2
City	:	HOUSTON
State	:	TX
Zip	:	77009-6551
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 HIGHLAND ST
Second Line	:	APT #2
City	:	HOUSTON
State	:	TX
Zip	:	77009-6551
Country	:	US
Telephone Number	:	832-524-0019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2013
Last Update Date	:	12/03/2013

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Directions to “ RACHEL GERKE MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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