Provider Demographics
NPI:1043291388
Name:KAHN, PERWAIZ (MD,)
Entity Type:Individual
Prefix:
First Name:PERWAIZ
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PINE FOREST DR STE 204
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-5303
Mailing Address - Country:US
Mailing Address - Phone:936-271-2222
Mailing Address - Fax:936-271-2221
Practice Address - Street 1:150 PINE FOREST DR STE 204
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-5303
Practice Address - Country:US
Practice Address - Phone:936-271-2222
Practice Address - Fax:936-271-2221
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2987207R00000X
AZ34691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
M2987OtherTEXAS MEDICAL BOARD LICENSE
AZ999592Medicaid
AZZ108187Medicare PIN