Provider Demographics
NPI:1326084039
Name:KHAN, SAJID RAZA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAJID
Middle Name:RAZA
Last Name:KHAN
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 24005
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66283-4005
Mailing Address - Country:US
Mailing Address - Phone:913-271-4142
Mailing Address - Fax:
Practice Address - Street 1:16100 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:713-413-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0432831207P00000X
KS390200000X
TXR3699207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200573860BMedicaid
KSP00635003OtherRR MEDICARE GROUP CG8899
KS200573860AMedicaid
41336014OtherBCBS KCMO SMMC EMERGENCY PHYSICIANS GROUP 01674018
41336024OtherBCBS KC MO ER PHYSICIANS SOUTH PA BCBS KCMO GROUP 30492021
KSR97000002Medicare PIN
41336014OtherBCBS KCMO SMMC EMERGENCY PHYSICIANS GROUP 01674018