Healthcare Provider Details

I. General information

NPI: 1780970947
Provider Name (Legal Business Name): SALMAN AZHAR RAHEEM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 W PARKER RD
PLANO TX
75093-8185
US

IV. Provider business mailing address

6200 W PARKER RD
PLANO TX
75093-8185
US

V. Phone/Fax

Practice location:
  • Phone: 972-891-8977
  • Fax:
Mailing address:
  • Phone: 972-891-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP9249
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberP9249
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: