Provider Demographics
NPI: | 1497773121 |
---|---|
Name: | KHANANI, NAZEER (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | NAZEER |
Middle Name: | |
Last Name: | KHANANI |
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: | PO BOX 650426 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75265-0426 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-715-5007 |
Mailing Address - Fax: | 972-715-5682 |
Practice Address - Street 1: | 1313 HERMANN DR |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77004-7005 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-527-5270 |
Practice Address - Fax: | 713-527-5689 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-18 |
Last Update Date: | 2023-05-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | M3612 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 8S7603 | Other | BCBS |
TX | 181702501 | Medicaid | |
TX | 02496089 | Other | TEXAS DRIVERS LICENSE |
TX | 60146408 | Other | DPS CERTIFICATE |
TX | P00385858 | Other | RAILROAD |
TX | 02496089 | Other | TEXAS DRIVERS LICENSE |
TX | TXB121057 | Medicare PIN |