Provider Demographics
NPI:1245764091
Name:JOSEPH, RACHEL MARIE (DO)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5592
Mailing Address - Country:US
Mailing Address - Phone:847-224-2598
Mailing Address - Fax:
Practice Address - Street 1:1441 S MIDLOTHIAN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5592
Practice Address - Country:US
Practice Address - Phone:847-224-2598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS7895208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program