Provider Demographics
NPI:1104826452
Name:KHAN, SARDAR DAUD (MD)
Entity Type:Individual
Prefix:
First Name:SARDAR
Middle Name:DAUD
Last Name:KHAN
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 1:17070 RED OAK DR.
Mailing Address - Street 2:SUITE 503
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2617
Mailing Address - Country:US
Mailing Address - Phone:281-444-2399
Mailing Address - Fax:281-444-3417
Practice Address - Street 1:17070 RED OAK DR.
Practice Address - Street 2:SUITE 503
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2617
Practice Address - Country:US
Practice Address - Phone:281-444-2399
Practice Address - Fax:281-444-3417
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7502207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355232501Medicaid
TX00NA60Medicare PIN
TX115628302Medicaid