MEDICARE: RAKHSHANDA LAYEEQUR-RAHMAN M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086X0206X	Surgical Oncology Physician	FTL 42888	TX
2	2086X0206X	Surgical Oncology Physician	FTL 43335	TX
3	2086X0206X	Surgical Oncology Physician	42510	TX
4	2086X0206X	Surgical Oncology Physician	P2283	TX
5	208600000X	Surgery Physician	225722	MA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1992787311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKHSHANDA LAYEEQUR-RAHMAN M.D.

Provider Business Mailing Address
First Line	:	1400 WALLACE BLVD
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1708
Country	:	US
Telephone Number	:	806-414-9650
Fax Number	:	806-354-5730

Provider Business Practice Location Address
First Line	:	1400 S COULTER ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1786
Country	:	US
Telephone Number	:	806-414-9650
Fax Number	:	806-354-5730

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

Provider Enumeration Date	:	11/20/2005
Last Update Date	:	12/20/2021

1400 S COULTER ST STE 2400
AMARILLO, TX
79106-1786

Practice Phone: 806-414-9100
Practice Fax: