Provider Demographics
NPI:1083319651
Name:KHAN, NUZHAT FIRDOS
Entity Type:Individual
Prefix:
First Name:NUZHAT
Middle Name:FIRDOS
Last Name:KHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 BRITTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3936
Mailing Address - Country:US
Mailing Address - Phone:281-620-8613
Mailing Address - Fax:
Practice Address - Street 1:955 DAIRY ASHFORD RD STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5307
Practice Address - Country:US
Practice Address - Phone:281-620-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional