Healthcare Provider Details

I. General information

NPI: 1700192432
Provider Name (Legal Business Name): RACHEL BETH GANDRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. RACHEL BETH REESE

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SCHOOL ST STE 26
TOMBALL TX
77375
US

IV. Provider business mailing address

455 SCHOOL ST STE 26
TOMBALL TX
77375-4595
US

V. Phone/Fax

Practice location:
  • Phone: 281-374-9700
  • Fax:
Mailing address:
  • Phone: 812-374-9700
  • Fax: 281-477-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN6873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: