Provider Demographics
NPI:1760427421
Name:REHMAN, SHABNAM ABDUL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHABNAM
Middle Name:ABDUL
Last Name:REHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 YAUPON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6457
Mailing Address - Country:US
Mailing Address - Phone:512-565-7137
Mailing Address - Fax:
Practice Address - Street 1:7733 YAUPON DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-6457
Practice Address - Country:US
Practice Address - Phone:512-565-7137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7382207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1049629-01Medicaid
TX104962901Medicaid
G62788Medicare UPIN
TX86283NMedicare PIN
TX104962901Medicaid