Rachaell Boutot
Student in an Organized Health Care Education/Training Program in San Antonio, TX. Individual provider (NPI-1).
Details
- NPI
- 1346129202
- Entity type
- Individual (NPI-1)
- Name
- Rachaell Boutot
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 27, 2025
- Certification date
- Aug 27, 2025
- Last updated
- Aug 27, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3551 Roger Brooke DrSan Antonio, TX 78234-4504
Phone 210-539-1047
Mailing address
3551 Roger Brooke DrJbsa Ft Sam Houston, TX 78234-4504
Phone 210-539-1047
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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