Healthcare Provider Details

I. General information

NPI: 1619433398
Provider Name (Legal Business Name): RACHEL BOURGEOIS SLAUGHTER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL BOURGEOIS SLAUGHTER DPT

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1973 NORTHWEST LOOP 410 STE 102
SAN ANTONIO TX
78213
US

IV. Provider business mailing address

1973 NW LOOP 410 STE 102
SAN ANTONIO TX
78213-2250
US

V. Phone/Fax

Practice location:
  • Phone: 210-812-3827
  • Fax:
Mailing address:
  • Phone: 210-812-3827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10804R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1315964
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1315964
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: