Provider Demographics
NPI:1609290204
Name:NIELSEN, RACHEL C (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:C
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 HIGHWAY 121
Mailing Address - Street 2:SUITE 292
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039
Mailing Address - Country:US
Mailing Address - Phone:817-684-0397
Mailing Address - Fax:817-684-8253
Practice Address - Street 1:3001 HIGHWAY 121
Practice Address - Street 2:SUITE 292
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039
Practice Address - Country:US
Practice Address - Phone:817-684-0397
Practice Address - Fax:817-684-8253
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1240317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist