Provider Demographics
NPI:1780187906
Name:KHOJA, IMRAN (BSN, RN)
Entity Type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:KHOJA
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 NEW TERRITORY BLVD APT 10204
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6556
Mailing Address - Country:US
Mailing Address - Phone:409-549-3981
Mailing Address - Fax:
Practice Address - Street 1:5556 NEW TERRITORY BLVD APT 10204
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6556
Practice Address - Country:US
Practice Address - Phone:409-549-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX939412163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse