Provider Demographics
NPI:1235139031
Name:KHAN, LAEEQ AHMAD (MD,FAAP)
Entity Type:Individual
Prefix:DR
First Name:LAEEQ
Middle Name:AHMAD
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD,FAAP
Other - Prefix:DR
Other - First Name:LEE
Other - Middle Name:AHMAD
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,FAAP
Mailing Address - Street 1:17202 RED OAK DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2647
Mailing Address - Country:US
Mailing Address - Phone:281-440-9500
Mailing Address - Fax:281-440-3715
Practice Address - Street 1:17202 RED OAK DR
Practice Address - Street 2:SUITE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2647
Practice Address - Country:US
Practice Address - Phone:281-440-9500
Practice Address - Fax:281-440-3715
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7139208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121100501Medicaid
TX121100501Medicaid