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General NPI Number Information
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NPI Number | 1891218814
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Entity Type | Individual
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Provider Name | RAEL OKOTH ECKENROED FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 300 W ARBROOK BLVD STE B
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City | ARLINGTON
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State | TX
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Zip | 76014-3105
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Country | US
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Telephone | 817-652-9192
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Fax |
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Provider Business Mailing Address
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Address Line | 12377 MERIT DR
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City | DALLAS
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State | TX
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Zip | 75251-2224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP134903
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP134903
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License Number State | TX
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