Provider Demographics
NPI:1114235199
Name:TOOTLE, RACHAEL ALINE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ALINE
Last Name:TOOTLE
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 N MASON RD STE 601
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6878
Mailing Address - Country:US
Mailing Address - Phone:713-589-3775
Mailing Address - Fax:713-589-3478
Practice Address - Street 1:2039 N MASON RD STE 601
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6878
Practice Address - Country:US
Practice Address - Phone:713-589-3775
Practice Address - Fax:713-589-3478
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121420363LF0000X
TX1883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP121420OtherTEXAS LICENSE NUMBER