Provider Demographics
NPI:1043226442
Name:RAUF, KHALIQ ABDUL (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALIQ
Middle Name:ABDUL
Last Name:RAUF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W COLLEGE ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051
Mailing Address - Country:US
Mailing Address - Phone:817-388-3440
Mailing Address - Fax:817-388-3440
Practice Address - Street 1:1650 W COLLEGE ST
Practice Address - Street 2:SUITE 150
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-388-3440
Practice Address - Fax:817-388-3440
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5077207R00000X
NC201000688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916032Medicaid
NC2076241Medicare PIN