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NPI Code Detail

MEDICARE: JEANNETTE R RACKHAM PA

MEDICARE: JEANNETTE R RACKHAM PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA03203TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28N9119OTHERTXBLUE SHIELD

General Provider Information

NPI Number : 1003878844
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNETTE R RACKHAM PA
Provider Business Mailing Address
First Line : 2700 W PLEASANT RUN RD
Second Line :
City : LANCASTER
State : TX
Zip : 75146-1079
Country : US
Telephone Number : 972-597-7326
Fax Number :
Provider Business Practice Location Address
First Line : 2600 W PLEASANT RUN RD
Second Line :
City : LANCASTER
State : TX
Zip : 75146-1114
Country : US
Telephone Number : 972-597-7326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 06/04/2026

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Directions to “ JEANNETTE R RACKHAM PA” Practice Location

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