Provider Demographics
NPI:1972580637
Name:RASILE, KAREN D (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:D
Last Name:RASILE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:D
Other - Last Name:RASILE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2346
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-2346
Mailing Address - Country:US
Mailing Address - Phone:979-530-8616
Mailing Address - Fax:979-421-6039
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-0901
Practice Address - Country:US
Practice Address - Phone:979-530-8616
Practice Address - Fax:979-421-6039
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24055103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131122707Medicaid
TX00K98HMedicare PIN
TX131122707Medicaid