Provider Demographics
NPI:1407824758
Name:KHAN, SALABAT NAWAZ (CP, LOP, BOCPO)
Entity Type:Individual
Prefix:
First Name:SALABAT
Middle Name:NAWAZ
Last Name:KHAN
Suffix:
Gender:M
Credentials:CP, LOP, BOCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 W QUINCE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8185
Mailing Address - Country:US
Mailing Address - Phone:956-686-9164
Mailing Address - Fax:
Practice Address - Street 1:1801 S 5TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2927
Practice Address - Country:US
Practice Address - Phone:956-631-0095
Practice Address - Fax:956-631-0131
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLOP#1002222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist