Provider Demographics
NPI:1790718203
Name:ABDULRAHMAN, RAMZI EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:RAMZI
Middle Name:EDUARDO
Last Name:ABDULRAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMZI
Other - Middle Name:E
Other - Last Name:ABDULRAHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-775-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM31312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G56239Medicare UPIN
TX8G5021Medicare ID - Type Unspecified