Provider Demographics
NPI:1447780523
Name:DO, KHA NAM (DC)
Entity Type:Individual
Prefix:DR
First Name:KHA
Middle Name:NAM
Last Name:DO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 MCKINNEY RANCH PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6866
Mailing Address - Country:US
Mailing Address - Phone:469-712-6306
Mailing Address - Fax:
Practice Address - Street 1:5005 MCKINNEY RANCH PKWY STE 220
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6866
Practice Address - Country:US
Practice Address - Phone:469-712-6306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor