Provider Demographics
NPI:1285786798
Name:R.A. TAHA, M.D., P.A.
Entity type:Organization
Organization Name:R.A. TAHA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:972-241-3011
Mailing Address - Street 1:8 MEDICAL PARKWAY, SUITE 302
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7843
Mailing Address - Country:US
Mailing Address - Phone:972-241-3011
Mailing Address - Fax:972-241-2325
Practice Address - Street 1:8 MEDICAL PKWY STE 302
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7843
Practice Address - Country:US
Practice Address - Phone:972-241-3011
Practice Address - Fax:972-241-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5575174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L028Medicare ID - Type Unspecified
TXB26836Medicare UPIN