Provider Demographics
NPI:1992787311
Name:LAYEEQUR-RAHMAN, RAKHSHANDA (MD)
Entity type:Individual
Prefix:
First Name:RAKHSHANDA
Middle Name:
Last Name:LAYEEQUR-RAHMAN
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 1:1400 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1708
Mailing Address - Country:US
Mailing Address - Phone:806-414-9650
Mailing Address - Fax:806-354-5730
Practice Address - Street 1:1400 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1786
Practice Address - Country:US
Practice Address - Phone:806-414-9650
Practice Address - Fax:806-354-5730
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXFTL 428882086X0206X
TXFTL 433352086X0206X
TX425102086X0206X
TXP22832086X0206X
MA225722208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM90605071Medicaid
OK200234360 AMedicaid
TX201675006Medicaid
MA2105802Medicaid
TX201675001Medicaid
NM90605071Medicaid
MAH93862Medicare UPIN