Provider Demographics
NPI:1720337173
Name:RMB FOOT AND ANKLE CENTER PA
Entity Type:Organization
Organization Name:RMB FOOT AND ANKLE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOBARAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-709-9099
Mailing Address - Street 1:777 E WHEATLAND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4918
Mailing Address - Country:US
Mailing Address - Phone:972-709-9099
Mailing Address - Fax:972-709-9141
Practice Address - Street 1:777 E WHEATLAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4918
Practice Address - Country:US
Practice Address - Phone:972-709-9099
Practice Address - Fax:972-709-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1933213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty