Provider Demographics
NPI:1033353206
Name:RAHIMI, ABDULWALI SAMAD (MD)
Entity Type:Individual
Prefix:
First Name:ABDULWALI
Middle Name:SAMAD
Last Name:RAHIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WALIULLAH
Other - Middle Name:
Other - Last Name:BAREKZAHAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 3RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2245
Mailing Address - Country:US
Mailing Address - Phone:817-466-9471
Mailing Address - Fax:940-767-4891
Practice Address - Street 1:100 VALLEY DR
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-6613
Practice Address - Country:US
Practice Address - Phone:405-238-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine