Basic Information
| Provider Information | |||||||||
| NPI: | 1992787311 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAYEEQUR-RAHMAN | ||||||||
| FirstName: | RAKHSHANDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 WALLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064149650 | ||||||||
| FaxNumber: | 8063545730 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 S COULTER ST | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064149650 | ||||||||
| FaxNumber: | 8063545730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2005 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | FTL 42888 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 2086X0206X | FTL 43335 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 2086X0206X | 42510 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 2086X0206X | P2283 | TX | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 208600000X | 225722 | MA | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 90605071 | 05 | NM | MEDICAID | 200234360 A | 05 | OK | MEDICAID | 201675006 | 05 | TX | MEDICAID | 2105802 | 05 | MA | MEDICAID | 201675001 | 05 | TX | MEDICAID |