Provider Demographics
NPI:1851911416
Name:KHAN, AISHA M (PA-C)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:M
Last Name:KHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5013 QUINCE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8185
Mailing Address - Country:US
Mailing Address - Phone:956-686-9164
Mailing Address - Fax:
Practice Address - Street 1:19255 PARK ROW STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7310
Practice Address - Country:US
Practice Address - Phone:346-200-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical