Provider Demographics
NPI:1154294833
Name:SK PHYSICAL MEDICINE, PLLC
Entity type:Organization
Organization Name:SK PHYSICAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ANISUR
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-574-5585
Mailing Address - Street 1:PO BOX 18045
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78480-8045
Mailing Address - Country:US
Mailing Address - Phone:361-288-2388
Mailing Address - Fax:361-288-2389
Practice Address - Street 1:6330 SARATOGA BLVD STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3482
Practice Address - Country:US
Practice Address - Phone:361-288-2388
Practice Address - Fax:361-288-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty