MEDICARE: RACHAL POST PT

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	225100000X	Physical Therapist	1145753	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1145753	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1770510455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAL POST PT

Provider Business Mailing Address
First Line	:	109 SHULT DR
Second Line	:	# 208
City	:	COLUMBUS
State	:	TX
Zip	:	78934-3015
Country	:	US
Telephone Number	:	979-732-8280
Fax Number	:	979-732-9740

Provider Business Practice Location Address
First Line	:	1024 MILAM ST
Second Line	:
City	:	COLUMBUS
State	:	TX
Zip	:	78934-2443
Country	:	US
Telephone Number	:	979-732-8280
Fax Number	:	979-732-9740

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	04/10/2008

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Directions to “ RACHAL POST PT” Practice Location

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