MEDICARE: DR. RAIFORD ADRIAN RATTAN D.P.M.

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	213E00000X	Podiatrist	1553	TX

General Provider Information

NPI Number	:	1558440750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAIFORD ADRIAN RATTAN D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 270504
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75027-0504
Country	:	US
Telephone Number	:	972-874-0116
Fax Number	:	972-874-0206

Provider Business Practice Location Address
First Line	:	2716 COCKRELL AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1119
Country	:	US
Telephone Number	:	214-724-5028
Fax Number	:

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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