Provider Demographics
NPI:1376039966
Name:KHAN, ALEEM RUBBUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEEM
Middle Name:RUBBUL
Last Name:KHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 PALO DURO RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-3242
Mailing Address - Country:US
Mailing Address - Phone:512-627-2857
Mailing Address - Fax:
Practice Address - Street 1:6111 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-3226
Practice Address - Country:US
Practice Address - Phone:512-454-9923
Practice Address - Fax:512-454-9866
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist