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General NPI Number Information
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NPI Number | 1558440750
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Entity Type | Individual
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Provider Name | RAIFORD ADRIAN RATTAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2716 COCKRELL AVE
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City | FORT WORTH
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State | TX
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Zip | 76109-1119
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Country | US
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Telephone | 214-724-5028
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270504
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City | FLOWER MOUND
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State | TX
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Zip | 75027-0504
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Country | US
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Telephone | 972-874-0116
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Fax | 972-874-0206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1553
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License Number State | TX
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