Provider Demographics
NPI:1316576879
Name:ULLAH, RUDAVA RAHMAT (MD)
Entity type:Individual
Prefix:
First Name:RUDAVA
Middle Name:RAHMAT
Last Name:ULLAH
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 1:2460 N I 35 STE 210
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5270
Mailing Address - Country:US
Mailing Address - Phone:469-530-0967
Mailing Address - Fax:469-294-1486
Practice Address - Street 1:2460 N I 35 STE 210
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5270
Practice Address - Country:US
Practice Address - Phone:469-530-0967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV9989207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology