Provider Demographics
NPI:1952899767
Name:REHAN, MEHBOOB AHMED (MD)
Entity type:Individual
Prefix:
First Name:MEHBOOB
Middle Name:AHMED
Last Name:REHAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 CATHEDRAL LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1490
Mailing Address - Country:US
Mailing Address - Phone:337-470-6498
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-488-4539
Practice Address - Fax:940-239-9906
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA345095207RI0200X
390200000X
TXU4911207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program