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NPI Code Detail

MEDICARE: MATTHEW RAKABA

MEDICARE: MATTHEW RAKABA
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
1207Q00000XFamily Medicine PhysicianW4935TX

General Provider Information

NPI Number : 1659066876
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW RAKABA
Provider Business Mailing Address
First Line : 1200 WOODHAVEN BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2376
Country : US
Telephone Number : 817-429-8300
Fax Number :
Provider Business Practice Location Address
First Line : 1200 WOODHAVEN BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-2376
Country : US
Telephone Number : 817-429-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 07/02/2026

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Directions to “ MATTHEW RAKABA ” Practice Location

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