Individual
RACHEL ANNA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-4095
(682) 885-7499
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
5101019186
MI
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
Q7228
TX
Other
Enumeration date
08/10/2011
Last updated
11/03/2022
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