MEDICARE: TEXAS ADDICTION TREATMENT CENTER PLLC

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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1851861868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS ADDICTION TREATMENT CENTER PLLC

Provider Business Mailing Address
First Line	:	6902 S PEEK RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1741
Country	:	US
Telephone Number	:	713-984-4546
Fax Number	:	800-930-4957

Provider Business Practice Location Address
First Line	:	6902 S PEEK RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1741
Country	:	US
Telephone Number	:	713-984-4546
Fax Number	:	800-930-4957

Authorized Official
Title or Position	:	OWNER
Name	:	RIAZ RAHMAN
Credential	:	MD
Telephone Number	:	321-443-9924

Provider Enumeration Date	:	12/03/2018
Last Update Date	:	05/14/2021

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