Provider Demographics
NPI:1790874709
Name:RAINVILLE, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:RAINVILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E BRIN ST
Mailing Address - Street 2:ATTN REIMBURSEMENT
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2938
Mailing Address - Country:US
Mailing Address - Phone:972-551-8730
Mailing Address - Fax:972-551-8513
Practice Address - Street 1:1200 E BRIN ST
Practice Address - Street 2:ATTN REIMBURSEMENT
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2938
Practice Address - Country:US
Practice Address - Phone:972-551-8730
Practice Address - Fax:972-551-8513
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ02122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9463OtherMCR B NTSH PTAN
TXTXB131995Medicare PIN
82T638Medicare PIN
F41134Medicare UPIN
TX8K9463OtherMCR B NTSH PTAN