Provider Demographics
NPI:1629633060
Name:RAHIMI, RAHMAN (DO)
Entity Type:Individual
Prefix:
First Name:RAHMAN
Middle Name:
Last Name:RAHIMI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8427 RIDGELEA ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-2637
Mailing Address - Country:US
Mailing Address - Phone:214-701-6747
Mailing Address - Fax:
Practice Address - Street 1:16633 DALLAS PKWY STE 150
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6812
Practice Address - Country:US
Practice Address - Phone:214-701-6747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18309208D00000X
390200000X
TXS8370208D00000X
FL0S183092083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine