Provider Demographics
NPI:1225259435
Name:KHAIR, HANI N (MD)
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:N
Last Name:KHAIR
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:PO BOX 2388
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-8388
Mailing Address - Country:US
Mailing Address - Phone:972-296-4308
Mailing Address - Fax:972-728-6290
Practice Address - Street 1:3537 S INTERSTATE 35 E
Practice Address - Street 2:SUITE 220
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:972-296-4308
Practice Address - Fax:972-728-6290
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-051331207R00000X
TXP3016207RI0200X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036122428Medicaid
IL036122428Medicaid
TXTXB154632Medicare PIN