Provider Demographics
NPI:1811999014
Name:RAHIM, ENAYET (MD)
Entity type:Individual
Prefix:
First Name:ENAYET
Middle Name:
Last Name:RAHIM
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 1:10904 SCARSDALE BLVD
Mailing Address - Street 2:#350-140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6068
Mailing Address - Country:US
Mailing Address - Phone:281-481-8500
Mailing Address - Fax:281-481-8520
Practice Address - Street 1:13630 BEAMER RD
Practice Address - Street 2:SUITE 114
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6069
Practice Address - Country:US
Practice Address - Phone:281-481-8500
Practice Address - Fax:281-481-8520
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047937207R00000X
TXM4920207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BL820OtherBCBSTX
TXP00662894OtherRRMEDICARE
GA00857612AMedicaid
TX190911102Medicaid
TXP00662894OtherRRMEDICARE
GA00857612AMedicaid
TX8F8101Medicare PIN