Basic Information
Provider Information
NPI: 1427587898
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOCKER
FirstName: RACHEL
MiddleName: PEARL
NamePrefix: MS.
NameSuffix:  
Credential: LPA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 5225 N LAMAR BLVD
Address2:  
City: AUSTIN
State: TX
PostalCode: 787511820
CountryCode: US
TelephoneNumber: 5124835800
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2017
LastUpdateDate: 06/08/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X37476TXY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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