Provider Demographics
NPI:1790194751
Name:MEYER-BOREL, RACHEL CATHERINE
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:CATHERINE
Last Name:MEYER-BOREL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:MEYER
Other - Last Name:BOREL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1801 FAIRFIELD AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4460
Mailing Address - Country:US
Mailing Address - Phone:318-703-5655
Mailing Address - Fax:
Practice Address - Street 1:1801 FAIRFIELD AVE STE 207
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101
Practice Address - Country:US
Practice Address - Phone:318-703-5655
Practice Address - Fax:318-606-5470
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1776-710T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist