Healthcare Provider Details

I. General information

NPI: 1790312452
Provider Name (Legal Business Name): RACHEL CLAIRE FRESQUES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date: 03/24/2020
Reactivation Date: 04/08/2020

III. Provider practice location address

4315 JAMES CASEY ST STE 200
AUSTIN TX
78745-3364
US

IV. Provider business mailing address

6210 E HWY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 512-383-9752
  • Fax:
Mailing address:
  • Phone: 512-483-9596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV2079
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: