Provider Demographics
NPI:1053433938
Name:MEMON, REHAN (MD)
Entity type:Individual
Prefix:
First Name:REHAN
Middle Name:
Last Name:MEMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3750 MEDICAL PARK DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539
Mailing Address - Country:US
Mailing Address - Phone:281-534-1133
Mailing Address - Fax:281-534-2190
Practice Address - Street 1:3750 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539
Practice Address - Country:US
Practice Address - Phone:281-534-1133
Practice Address - Fax:281-534-2190
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP6037207LA0401X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EB512OtherBLUE CROSS/ BLUE SHIELD
TX50198989OtherDPS
TXFM1057492OtherDEA