Provider Demographics
NPI:1487390464
Name:TORRES, RACHEL CHRISTINE (OTR)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CHRISTINE
Last Name:TORRES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:CHRISTINE
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2013 OXFORD CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-3758
Mailing Address - Country:US
Mailing Address - Phone:817-996-4968
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 8574
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:512-522-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-8641225X00000X
WAOT61235989225X00000X
TX120555225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty