Provider Demographics
NPI:1518306596
Name:RAHMAN, RIAZ RIZA
Entity Type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:RIZA
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 KADE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3657
Mailing Address - Country:US
Mailing Address - Phone:337-388-6200
Mailing Address - Fax:337-388-6201
Practice Address - Street 1:422 KADE ST STE 1
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3657
Practice Address - Country:US
Practice Address - Phone:337-388-6200
Practice Address - Fax:337-388-6201
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA324206207RC0000X, 207RI0011X
PAMT204022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine