Provider Demographics
NPI:1366180051
Name:BUSH, RACHEL ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:BUSH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 E INTERSTATE 20
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1119
Mailing Address - Country:US
Mailing Address - Phone:815-793-2510
Mailing Address - Fax:817-467-5819
Practice Address - Street 1:350 E INTERSTATE 20 STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1119
Practice Address - Country:US
Practice Address - Phone:214-254-4299
Practice Address - Fax:817-467-5819
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10697152W00000X, 152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program