Provider Demographics
NPI:1790710648
Name:KHAN, ATAUR-REHMAN RIZWAN (MD)
Entity Type:Individual
Prefix:
First Name:ATAUR-REHMAN
Middle Name:RIZWAN
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 1:21212 NORTHWEST FRWY. STE 555
Mailing Address - Street 2:NORTHWEST CARDIOLOGY CONSULTANTS, P.A.
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-955-0786
Mailing Address - Fax:281-955-8848
Practice Address - Street 1:21212 NORTHWEST FRWY. STE 555
Practice Address - Street 2:NORTHWEST CARDIOLOGY CONSULTANTS, P.A.
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-955-0786
Practice Address - Fax:281-955-8848
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6461207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164387601Medicaid
TX164387601Medicaid
TX8B7010Medicare PIN
TX164387601Medicare ID - Type Unspecified