Basic Information
| Provider Information | |||||||||
| NPI: | 1790874709 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAINVILLE | ||||||||
| FirstName: | KAREN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 E BRIN ST | ||||||||
| Address2: | ATTN REIMBURSEMENT | ||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751602938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725518730 | ||||||||
| FaxNumber: | 9725518513 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 E BRIN ST | ||||||||
| Address2: | ATTN REIMBURSEMENT | ||||||||
| City: | TERRELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751602938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725518730 | ||||||||
| FaxNumber: | 9725518513 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 09/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | J0212 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 8K9463 | 01 | TX | MCR B NTSH PTAN | OTHER |