Provider Demographics
NPI:1518273036
Name:KHAN, SHAGUFTA P (SONOGRAPHER)
Entity Type:Individual
Prefix:
First Name:SHAGUFTA
Middle Name:P
Last Name:KHAN
Suffix:
Gender:F
Credentials:SONOGRAPHER
Other - Prefix:
Other - First Name:SHAGUFTA
Other - Middle Name:
Other - Last Name:PARVEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SONOGRAPHER
Mailing Address - Street 1:3137 ESTERS RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-2837
Mailing Address - Country:US
Mailing Address - Phone:972-904-8360
Mailing Address - Fax:
Practice Address - Street 1:3137 ESTERS RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-2837
Practice Address - Country:US
Practice Address - Phone:972-904-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00072951246X00000X
TX1140792471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography