Provider Demographics
NPI:1205196946
Name:HOGAN, RACHEL (DO)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:17183 INTERSTATE 45 S
Mailing Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 640
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385
Mailing Address - Country:US
Mailing Address - Phone:936-270-3073
Mailing Address - Fax:936-270-3075
Practice Address - Street 1:17183 INTERSTATE 45 S
Practice Address - Street 2:MEDICAL OFFICE BUILDING 1, SUITE 640
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:936-270-3073
Practice Address - Fax:936-270-3075
Is Sole Proprietor?:No
Enumeration Date:2012-05-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8188207R00000X
ORDO171112208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500686065Medicaid
ORR183007Medicare PIN