Provider Demographics
NPI:1619433398
Name:SLAUGHTER, RACHEL BOURGEOIS (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:BOURGEOIS
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:BOURGEOIS
Other - Last Name:SLAUGHTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:1973 NW LOOP 410 STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2250
Mailing Address - Country:US
Mailing Address - Phone:210-812-3827
Mailing Address - Fax:
Practice Address - Street 1:1973 NORTHWEST LOOP 410
Practice Address - Street 2:STE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213
Practice Address - Country:US
Practice Address - Phone:210-812-3827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10804R225100000X
1315964225100000X
TX1315964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist