Provider Demographics
NPI:1376133405
Name:WADE, RACHEL MERLEY
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MERLEY
Last Name:WADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11810 HAMMOND DR APT 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3864
Mailing Address - Country:US
Mailing Address - Phone:281-408-6804
Mailing Address - Fax:
Practice Address - Street 1:11810 HAMMOND DR APT 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3864
Practice Address - Country:US
Practice Address - Phone:281-408-6804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1026785164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse