Provider Demographics
NPI:1821049271
Name:KHAN, SHARMIN A (ANP)
Entity Type:Individual
Prefix:
First Name:SHARMIN
Middle Name:A
Last Name:KHAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 FOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7606
Mailing Address - Country:US
Mailing Address - Phone:713-343-2679
Mailing Address - Fax:713-343-2681
Practice Address - Street 1:2660 FOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7606
Practice Address - Country:US
Practice Address - Phone:713-343-2679
Practice Address - Fax:713-343-2681
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX740539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR026861Medicaid
MK1150440OtherDEA
133205Medicare ID - Type Unspecified
Q37732Medicare UPIN