Provider Demographics
NPI:1760800734
Name:KHAN, AAMER HASAN
Entity Type:Individual
Prefix:
First Name:AAMER
Middle Name:HASAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE D569
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6903
Mailing Address - Country:US
Mailing Address - Phone:972-566-8340
Mailing Address - Fax:972-566-8338
Practice Address - Street 1:7777 FOREST LN STE D569
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6903
Practice Address - Country:US
Practice Address - Phone:972-566-8340
Practice Address - Fax:972-566-8338
Is Sole Proprietor?:No
Enumeration Date:2014-04-06
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS62262080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program