MEDICARE: SK PHYSICAL MEDICINE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1154294833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SK PHYSICAL MEDICINE, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 18045
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78480-8045
Country	:	US
Telephone Number	:	361-288-2388
Fax Number	:	361-288-2389

Provider Business Practice Location Address
First Line	:	6330 SARATOGA BLVD STE B
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-3482
Country	:	US
Telephone Number	:	361-288-2388
Fax Number	:	361-288-2389

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MOHAMMAD ANISUR RAHMAN
Credential	:	MD
Telephone Number	:	347-574-5585

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	12/02/2025

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