Provider Demographics
NPI:1942253372
Name:HAQQANI, MUHAMMAD ABDUR RAHIM (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ABDUR RAHIM
Last Name:HAQQANI
Suffix:
Gender:M
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:PO BOX 250464
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0464
Mailing Address - Country:US
Mailing Address - Phone:469-213-6400
Mailing Address - Fax:
Practice Address - Street 1:4500 HILLCREST RD STE 115
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5403
Practice Address - Country:US
Practice Address - Phone:469-213-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL83612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U1295OtherBCBS
TXP00658222OtherRAILROAD MEDICARE
TX165450103Medicaid
TXI08145Medicare UPIN
TXP00658222OtherRAILROAD MEDICARE