Provider Demographics
NPI:1922129774
Name:KHAN, ABDUL HAQ (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:HAQ
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17183 INTERSTATE 45 S
Mailing Address - Street 2:MEDICAL OFFICE BLDG 1; SUITE 640
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3312
Mailing Address - Country:US
Mailing Address - Phone:936-270-3880
Mailing Address - Fax:936-270-3881
Practice Address - Street 1:17183 INTERSTATE 45 S
Practice Address - Street 2:MEDICAL OFFICE BLDG-1, SUITE 640
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3312
Practice Address - Country:US
Practice Address - Phone:936-270-3880
Practice Address - Fax:936-270-3881
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI52028-20207RG0100X
CO45722207RG0100X
TXT3113207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology