Provider Demographics
NPI:1699945956
Name:HYDARI, RAKHSHI (MD)
Entity type:Individual
Prefix:
First Name:RAKHSHI
Middle Name:
Last Name:HYDARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N HIGHLAND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7371
Mailing Address - Country:US
Mailing Address - Phone:903-347-0001
Mailing Address - Fax:
Practice Address - Street 1:321 N HIGHLAND AVE STE 105
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7371
Practice Address - Country:US
Practice Address - Phone:903-347-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51135-20207Q00000X
TXP7283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIFH0015962OtherDEA