Provider Demographics
NPI:1235139239
Name:KHAN, ATTIYA SHAHEEN (MD)
Entity Type:Individual
Prefix:
First Name:ATTIYA
Middle Name:SHAHEEN
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21212 NORTHWEST FRWY. STE. 555
Mailing Address - Street 2:NORTHWEST CARDIOLOGY CONSULTANTS, P.A.
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-955-0786
Mailing Address - Fax:281-955-8848
Practice Address - Street 1:21212 NORTHWEST FRWY. STE. 555
Practice Address - Street 2:NORTHWEST CARDIOLOGY CONSULTANTS, P.A.
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-955-0786
Practice Address - Fax:281-955-8848
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8916207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100020001Medicaid
TX100020001Medicaid
81G486Medicare PIN
TX81G486Medicare ID - Type Unspecified