Provider Demographics
NPI:1376819268
Name:KHALAF, HAMZAH SUHAIL (MD)
Entity Type:Individual
Prefix:
First Name:HAMZAH
Middle Name:SUHAIL
Last Name:KHALAF
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 1:790 GENERATIONS DR STE 810
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6866
Mailing Address - Country:US
Mailing Address - Phone:830-302-4700
Mailing Address - Fax:830-302-4700
Practice Address - Street 1:790 GENERATIONS DR STE 810
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6866
Practice Address - Country:US
Practice Address - Phone:830-302-4700
Practice Address - Fax:830-302-4700
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7402207WX0107X, 207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX359643901Medicaid
TX359643903Medicaid
TX359643904OtherCSHCN