Healthcare Provider Details

I. General information

NPI: 1699945956
Provider Name (Legal Business Name): RAKHSHI HYDARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 03/07/2023
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N HIGHLAND AVE STE 105
SHERMAN TX
75092-7371
US

IV. Provider business mailing address

321 N HIGHLAND AVE STE 105
SHERMAN TX
75092-7371
US

V. Phone/Fax

Practice location:
  • Phone: 903-347-0001
  • Fax:
Mailing address:
  • Phone: 903-347-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number51135-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP7283
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: