Provider Demographics
NPI:1407084114
Name:HEAD, RACHEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:B
Last Name:HEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:LYNN
Other - Last Name:BAUBLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:617 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1247
Mailing Address - Country:US
Mailing Address - Phone:936-305-5109
Mailing Address - Fax:936-305-5112
Practice Address - Street 1:617 RUSSELL BLVD
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1247
Practice Address - Country:US
Practice Address - Phone:936-305-5109
Practice Address - Fax:936-305-5112
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8911208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3761470Medicaid