Provider Demographics
NPI:1629493986
Name:GOODMAN, RACHEL (OT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 JACKSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3668
Mailing Address - Country:US
Mailing Address - Phone:281-344-1808
Mailing Address - Fax:281-344-1807
Practice Address - Street 1:1500 JACKSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3668
Practice Address - Country:US
Practice Address - Phone:281-344-1808
Practice Address - Fax:281-344-1807
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115946174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist