Provider Demographics
NPI:1356667547
Name:RAHIM, ROBBY
Entity type:Individual
Prefix:
First Name:ROBBY
Middle Name:
Last Name:RAHIM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 CARIBOU DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4325
Mailing Address - Country:US
Mailing Address - Phone:970-484-4757
Mailing Address - Fax:970-484-4759
Practice Address - Street 1:9907 DAISY CLOVER CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-1459
Practice Address - Country:US
Practice Address - Phone:970-484-4757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY17662C2085R0202X
NECP11292085R0202X
COCDR.00045692085R0202X
TXQ59092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology