MEDICARE: DR. RAHIM RUKNUDIN SEWANI DO, PHD

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	207Q00000X	Family Medicine Physician	7272	OK
2	207Q00000X	Family Medicine Physician	OS19439	FL
3	207Q00000X	Family Medicine Physician	T7728	TX

General Provider Information

NPI Number	:	1205463767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAHIM RUKNUDIN SEWANI DO, PHD

Provider Business Mailing Address
First Line	:	3905 HEDGCOXE RD UNIT 250328
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-0858
Country	:	US
Telephone Number	:	817-545-7700
Fax Number	:	817-545-2298

Provider Business Practice Location Address
First Line	:	1701 FOREST RIDGE DR
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76022-7959
Country	:	US
Telephone Number	:	817-545-7700
Fax Number	:	817-545-2298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	05/26/2025

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