Provider Demographics
NPI:1366002487
Name:KHAN, HASAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:HASAN
Middle Name:A
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0709
Mailing Address - Country:US
Mailing Address - Phone:409-747-2849
Mailing Address - Fax:409-772-7120
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0709
Practice Address - Country:US
Practice Address - Phone:409-747-2849
Practice Address - Fax:409-772-7120
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program