Provider Demographics
NPI:1194463661
Name:KHAN, AMNA (DDS)
Entity Type:Individual
Prefix:
First Name:AMNA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 RIDGELEY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6726
Mailing Address - Country:US
Mailing Address - Phone:713-614-5224
Mailing Address - Fax:
Practice Address - Street 1:1700 N ZARAGOZA RD STE 133
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7965
Practice Address - Country:US
Practice Address - Phone:915-856-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist