Provider Demographics
NPI:1891867297
Name:KHAN, YASMIN B (M D P A)
Entity Type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:B
Last Name:KHAN
Suffix:
Gender:F
Credentials:M D P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 W CAMPBELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2990
Mailing Address - Country:US
Mailing Address - Phone:972-498-4510
Mailing Address - Fax:972-498-4511
Practice Address - Street 1:1080 W CAMPBELL RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2990
Practice Address - Country:US
Practice Address - Phone:972-498-4510
Practice Address - Fax:972-498-4511
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1092207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG66953Medicare UPIN
TX00560QMedicare ID - Type Unspecified