Healthcare Provider Details

I. General information

NPI: 1629633060
Provider Name (Legal Business Name): RAHMAN RAHIMI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16633 DALLAS PKWY STE 150
ADDISON TX
75001-6812
US

IV. Provider business mailing address

8427 RIDGELEA ST
DALLAS TX
75209-2637
US

V. Phone/Fax

Practice location:
  • Phone: 214-701-6747
  • Fax:
Mailing address:
  • Phone: 214-701-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS18309
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberS8370
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number0S18309
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: