Provider Demographics
NPI:1730146101
Name:RAHN, DAVID DWIGHT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:DWIGHT
Last Name:RAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:DWIGHT
Other - Last Name:RAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-648-6430
Mailing Address - Fax:214-648-0328
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9032
Practice Address - Country:US
Practice Address - Phone:214-648-6430
Practice Address - Fax:214-648-0328
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2026207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176253601Medicaid
TX8D8203Medicare ID - Type Unspecified
TX176253601Medicaid