Doctor Name: | DR. RAHA M. MOBARAK |
NPI Number: | 1275742074 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 311 |
Business Practice Address: | 777 E Wheatland Rd Suite 102 Duncanville, TX - 751164918 |
Business Phone Number: | 9727099099 |
Business Fax Number: | 9727099141 |
Mailing Address: | 1675 Republic Pkwy, Ste 101 MESQUITE |
State: | TX |
Postal Code: | 751506902 |
Phone Number: | 9727099099 |
Fax Number: | 9727099141 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 02/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 311 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |