Provider Demographics
NPI:1003308958
Name:CLINE, RACHEL L
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:CLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76707-2261
Mailing Address - Country:US
Mailing Address - Phone:254-313-4200
Mailing Address - Fax:254-313-4549
Practice Address - Street 1:3900 NE STALLINGS DR STE 101
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2111
Practice Address - Country:US
Practice Address - Phone:936-559-8770
Practice Address - Fax:936-559-8773
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10063982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine