Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | BP10063982 | TX |
NPI | 1003308958 |
---|---|
Provider Name | Rachel L Cline |
First Address | Waco, TX 76707-2261 |
Second Address | Waco, TX 76707-2261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 05/06/2018 |