Provider Demographics
NPI:1659473809
Name:UDDIN, RAHMAN SAHADAT (MD)
Entity Type:Individual
Prefix:MR
First Name:RAHMAN
Middle Name:SAHADAT
Last Name:UDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77572
Mailing Address - Country:US
Mailing Address - Phone:281-867-0291
Mailing Address - Fax:281-867-0292
Practice Address - Street 1:10407 W FAIRMONT PKWY
Practice Address - Street 2:STE B
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571
Practice Address - Country:US
Practice Address - Phone:281-867-0291
Practice Address - Fax:281-867-0292
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9442208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004196Medicare ID - Type Unspecified
H12381Medicare UPIN