Provider Demographics
NPI:1023509601
Name:MERRIFIELD, RACHEL ELISE (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELISE
Last Name:MERRIFIELD
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 1:4002 S LOOP 256 STE A
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-8492
Mailing Address - Country:US
Mailing Address - Phone:903-731-5442
Mailing Address - Fax:
Practice Address - Street 1:4002 S LOOP 256 STE M
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-8496
Practice Address - Country:US
Practice Address - Phone:903-731-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-19
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2683208000000X
HI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI7487Other20 ALLOPATHIC & OSTEOPATHIC PHYSICIAN