Provider Demographics
NPI:1952721656
Name:RAHMAN, MUJTABA AHMAD (MD)
Entity type:Individual
Prefix:
First Name:MUJTABA
Middle Name:AHMAD
Last Name:RAHMAN
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:ONE BAYLOR PLAZA
Mailing Address - Street 2:MS: BCM120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-5117
Mailing Address - Fax:713-798-6374
Practice Address - Street 1:ONE BAYLOR PLAZA
Practice Address - Street 2:MS: BCM120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5117
Practice Address - Fax:713-798-6374
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5798207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology