MEDICARE: DR. RACHEL B HEAD MD

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
1	208800000X	Urology Physician	P8911	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1407084114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL B HEAD MD

Provider Business Mailing Address
First Line	:	617 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1247
Country	:	US
Telephone Number	:	936-305-5109
Fax Number	:	936-305-5112

Provider Business Practice Location Address
First Line	:	617 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1247
Country	:	US
Telephone Number	:	936-305-5109
Fax Number	:	936-305-5112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2009
Last Update Date	:	02/10/2026

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Directions to “ DR. RACHEL B HEAD MD” Practice Location

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