Provider Demographics
NPI:1891849097
Name:RAHMAN, ABU A (DC)
Entity Type:Individual
Prefix:MR
First Name:ABU
Middle Name:A
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 W PIONEER PKW
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4852
Mailing Address - Country:US
Mailing Address - Phone:972-642-4040
Mailing Address - Fax:972-642-4040
Practice Address - Street 1:571 W PIONEER PKW
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4852
Practice Address - Country:US
Practice Address - Phone:972-642-4040
Practice Address - Fax:972-642-4040
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC5055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
617748OtherUNITED
8A5460OtherBC
8286MOMedicare ID - Type Unspecified
T83365Medicare UPIN