Active NPI
Mohammad Adeelur Rehman, D.M.D
- Dentist
- Fort Sam Houston, TX
National Provider Identifier
1477091312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030951
- Practice address
- 1811 Army Blvd
Fort Sam Houston, TX 78234-2686 - Phone
- (210) 221-0826
- NPI assigned
- Feb 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019030951 | IL | Primary |
Addresses
Primary practice location
1811 Army Blvd
Fort Sam Houston, TX 78234-2686
Mailing address
2510 S 31St St
Apt 3205
Temple, TX 76504-7118
Phone (630) 962-6867
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019030951 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486684800000",
"number": "1477091312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 S 31ST ST",
"address_2": "APT 3205",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765047118",
"telephone_number": "630-962-6867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 ARMY BLVD",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782342686",
"telephone_number": "210-221-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REHMAN",
"first_name": "MOHAMMAD",
"middle_name": "ADEELUR",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-10",
"last_updated": "2017-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.