Provider Demographics
NPI:1316972698
Name:ABDEL RAHMAN, AHMED BASEM (MD, FRCPC, MBA)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:BASEM
Last Name:ABDEL RAHMAN
Suffix:
Gender:M
Credentials:MD, FRCPC, MBA
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:
Other - Last Name:RAHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1160 HORIZON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5498
Mailing Address - Country:US
Mailing Address - Phone:972-498-1100
Mailing Address - Fax:972-498-1300
Practice Address - Street 1:1160 HORIZON RD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-5498
Practice Address - Country:US
Practice Address - Phone:972-498-1100
Practice Address - Fax:972-498-1300
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2190207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX687378OtherMEDICARE
TX344379801Medicaid