Provider Demographics
NPI:1578570867
Name:KHAN, JUNAID AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:JUNAID
Middle Name:AHMAD
Last Name:KHAN
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 57831
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7831
Mailing Address - Country:US
Mailing Address - Phone:281-557-0001
Mailing Address - Fax:281-554-7403
Practice Address - Street 1:450 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4234
Practice Address - Country:US
Practice Address - Phone:281-557-0001
Practice Address - Fax:281-554-7403
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167035801Medicaid
TXG39230Medicare UPIN
TX8B3492Medicare PIN