Provider Demographics
NPI:1184630840
Name:KHAN, SHAZIA (MD)
Entity Type:Individual
Prefix:
First Name:SHAZIA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAZIA
Other - Middle Name:
Other - Last Name:AHSAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6200 W PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8185
Mailing Address - Country:US
Mailing Address - Phone:972-981-3225
Mailing Address - Fax:972-981-3967
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8185
Practice Address - Country:US
Practice Address - Phone:972-981-3225
Practice Address - Fax:972-981-3967
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006003812207R00000X
TXP6659207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine