Provider Demographics
NPI:1225138753
Name:MOHAMMAD O. KHAN, M.D., P.A.
Entity Type:Organization
Organization Name:MOHAMMAD O. KHAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:O
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-955-0012
Mailing Address - Street 1:10924 GRANT RD
Mailing Address - Street 2:BMB412
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4445
Mailing Address - Country:US
Mailing Address - Phone:281-955-0012
Mailing Address - Fax:
Practice Address - Street 1:18955 MEMORIAL NORTH
Practice Address - Street 2:#300
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4347
Practice Address - Country:US
Practice Address - Phone:281-955-0012
Practice Address - Fax:832-237-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0328207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH29232Medicare UPIN