Provider Demographics
NPI:1477683886
Name:UR REHMAN, MOHAMMED SHAKEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SHAKEEL
Last Name:UR REHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMED
Other - Middle Name:SHAKEEL
Other - Last Name:UR REHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:601 W MAPLE AVE
Mailing Address - Street 2:SUITE NUMBER 704
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-5335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:940 W STACY RD STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5215
Practice Address - Country:US
Practice Address - Phone:214-833-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU9100208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR168401001Medicaid
OK200110300AMedicaid
OK200110300AMedicaid