MEDICARE: DR. EMRAN RAHMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	17201	MS
2	207RI0200X	Infectious Disease Physician	M4921	TX

General Provider Information

NPI Number	:	1528015864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMRAN RAHMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 660599
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1936 AMELIA CT
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7706
Country	:	US
Telephone Number	:	214-590-5637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/25/2014

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