Provider Demographics
NPI:1447229000
Name:KHOKHAR, MANMOHAN S (MD)
Entity Type:Individual
Prefix:
First Name:MANMOHAN
Middle Name:S
Last Name:KHOKHAR
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 1:1776 WOODSTEAD CT STE 208
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1480
Mailing Address - Country:US
Mailing Address - Phone:877-749-7428
Mailing Address - Fax:512-628-3314
Practice Address - Street 1:1401 JOHNSTON WILLIS DRIVE
Practice Address - Street 2:5 E IN PT REHAB
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4722
Practice Address - Country:US
Practice Address - Phone:804-467-2258
Practice Address - Fax:804-378-2248
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039867208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
C08460OtherMEDICARE GROUP NUMBER
VA006803181Medicaid
C08460OtherMEDICARE GROUP NUMBER
VA006803181Medicaid