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General NPI Number Information
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NPI Number | 1043680374
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Entity Type | Organization
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Legal Business Name | RACHEL B. HEAD, MD, PLLC
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Dates
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Enumeration Date | 09/29/2015
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 1320 N UNIVERSITY DR
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4269
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Country | US
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Telephone | 936-560-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 440 SPRING CREEK DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-6960
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Country | US
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Telephone | 769-226-3001
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Fax |
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Authorized Official
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Title or Position | UROLOGIST
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Name | DR. RACHEL BAUBLET HEAD
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Credential | MD
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Telephone | 936-560-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | P8911
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License Number State | TX
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