# EVERSHINE MED PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EvershineMed Bedford
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982448296
- **Authorized official:** DR. RAHIM RUKNUDIN SEWANI DO, PHD (MANAGING MEMBER)
- **Authorized official phone:** (630) 853-7049

## Contact information

- **Practice address:** 1701 FOREST RIDGE DR, BEDFORD, TX 76022-7959
- **Practice address phone:** (817) 545-7700
- **Practice address fax:** (817) 545-2298
- **Mailing address:** 1701 FOREST RIDGE DR, BEDFORD, TX 76022-7959
- **Mailing address phone:** (817) 545-7700
- **Mailing address fax:** (817) 545-2298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/21/2024
- **Last updated:** 09/09/2024