Provider Demographics
NPI:1114977907
Name:KHAN, ARSHAD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARSHAD
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 METROPOLITAN DR STE 205
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2409
Mailing Address - Country:US
Mailing Address - Phone:409-234-7088
Mailing Address - Fax:409-892-8237
Practice Address - Street 1:6025 METROPOLITAN DR STE 205
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706
Practice Address - Country:US
Practice Address - Phone:409-234-7088
Practice Address - Fax:409-892-8237
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16005108213ES0103X
IN07001021A213ES0103X
TX2363213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2363OtherMEDICAL LICENSE
IN07001021AOtherIN LICENSE
ILK08162Medicare ID - Type Unspecified