Healthcare Provider Details

I. General information

NPI: 1205938107
Provider Name (Legal Business Name): STEVE SINGH RAKKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SUDEEP SINGH RAKKAR

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 W SPRING CREEK PKWY SUITE A300
PLANO TX
75023
US

IV. Provider business mailing address

2105 W SPRING CREEK PKWY SUITE A300
PLANO TX
75023
US

V. Phone/Fax

Practice location:
  • Phone: 972-208-2900
  • Fax: 972-491-6750
Mailing address:
  • Phone: 972-208-2900
  • Fax: 972-491-6750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG5511
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: