Provider Demographics
NPI:1033640909
Name:KHUWAJA, SAMREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMREEN
Middle Name:
Last Name:KHUWAJA
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 1:4116 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-7209
Mailing Address - Country:US
Mailing Address - Phone:409-999-2409
Mailing Address - Fax:
Practice Address - Street 1:4116 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7209
Practice Address - Country:US
Practice Address - Phone:409-999-2409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine