Provider Demographics
NPI:1457715492
Name:ZETTL, RACHEL ELIZABETH (MD, MED)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:ZETTL
Suffix:
Gender:F
Credentials:MD, MED
Other - Prefix:
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Mailing Address - Street 1:711 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-9130
Mailing Address - Country:US
Mailing Address - Phone:972-552-5559
Mailing Address - Fax:972-552-5499
Practice Address - Street 1:711 W BROAD ST
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-9130
Practice Address - Country:US
Practice Address - Phone:972-552-5559
Practice Address - Fax:972-552-5499
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR93252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program