Provider Demographics
NPI:1659718898
Name:KHAN, ANWAR A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-923-7929
Practice Address - Street 1:910 WAGNER AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3213
Practice Address - Country:US
Practice Address - Phone:210-922-7000
Practice Address - Fax:210-923-4167
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist