Basic Information
| Provider Information | |||||||||
| NPI: | 1609800358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAKERS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16107 KENSINGTON DR | ||||||||
| Address2: | STE 126 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774794224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812010657 | ||||||||
| FaxNumber: | 2813360764 | ||||||||
| Practice Location | |||||||||
| Address1: | 16902 SOUTHWEST FWY | ||||||||
| Address2: | STE 108 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774793573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323429205 | ||||||||
| FaxNumber: | 2813360764 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 01/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036112222 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | M4461 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 188279707 | 05 | TX | MEDICAID |