Healthcare Provider Details

I. General information

NPI: 1093386377
Provider Name (Legal Business Name): RACHEL ELIZABETH FIKAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 W SAM HOUSTON PKWY S STE 110
HOUSTON TX
77099-5153
US

IV. Provider business mailing address

1701 OAK HILL LN APT 1128
AUSTIN TX
78744-2239
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax: 954-982-6491
Mailing address:
  • Phone: 361-772-3029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50757
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: