Provider Demographics
NPI:1629061346
Name:KHAN, SALEEM (MD)
Entity Type:Individual
Prefix:
First Name:SALEEM
Middle Name:
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 1:600 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-5601
Mailing Address - Country:US
Mailing Address - Phone:903-892-6823
Mailing Address - Fax:903-893-5720
Practice Address - Street 1:600 N HIGHLAND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5601
Practice Address - Country:US
Practice Address - Phone:903-892-6823
Practice Address - Fax:903-893-5720
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE94902086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098160706Medicaid
TX8AN629OtherBCBS
TXD66733Medicare UPIN
TX098160706Medicaid
TX8AN629OtherBCBS