Healthcare Provider Details

I. General information

NPI: 1558297747
Provider Name (Legal Business Name): MARIA ABDUL REHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 DYER ST
EL PASO TX
79904-6235
US

IV. Provider business mailing address

4241 MAYCRAFT DR
RICHARDSON TX
75082-5312
US

V. Phone/Fax

Practice location:
  • Phone: 940-220-7833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42560
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: