Provider Demographics
NPI:1164478962
Name:KHAN, ABDUL RASHEED (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:RASHEED
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 1:4355 INTERSTATE 30 STE 100
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2035
Mailing Address - Country:US
Mailing Address - Phone:214-501-5426
Mailing Address - Fax:214-501-5425
Practice Address - Street 1:4355 INTERSTATE 30 STE 100
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2035
Practice Address - Country:US
Practice Address - Phone:214-501-5426
Practice Address - Fax:214-501-5425
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024076207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1487015Medicaid
LA5A748Medicare ID - Type Unspecified
LAG74474Medicare UPIN