Provider Demographics
NPI:1760777890
Name:YASMIN B. KHAN, MD PA
Entity Type:Organization
Organization Name:YASMIN B. KHAN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:972-498-4510
Mailing Address - Street 1:1080 W CAMPBELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2990
Mailing Address - Country:US
Mailing Address - Phone:972-498-4510
Mailing Address - Fax:972-498-4511
Practice Address - Street 1:1080 W CAMPBELL RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-498-4510
Practice Address - Fax:972-498-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1092207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00560QMedicare PIN
G66953Medicare UPIN