Provider Demographics
NPI:1356348940
Name:BISHOP, RACHEL D (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:BISHOP
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 1:4710 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4526
Mailing Address - Country:US
Mailing Address - Phone:713-441-9040
Mailing Address - Fax:713-838-8061
Practice Address - Street 1:4710 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4526
Practice Address - Country:US
Practice Address - Phone:713-441-9040
Practice Address - Fax:713-838-8061
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2014-04-29
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
TXK9228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153828204Medicaid
TX153828202Medicaid
TXP01254098OtherMEDICARE RR
TX153828202Medicaid
TX153828204Medicaid