Healthcare Provider Details

I. General information

NPI: 1508323031
Provider Name (Legal Business Name): RACHEL BAHR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 8TH AVE STE 600
FORT WORTH TX
76104-2597
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 682-303-0376
  • Fax:
Mailing address:
  • Phone: 682-885-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP138956
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: