Provider Demographics
NPI:1932303245
Name:AHMED KHAN MD PA
Entity Type:Organization
Organization Name:AHMED KHAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-307-3920
Mailing Address - Street 1:2919 HAMPTON F222
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224
Mailing Address - Country:US
Mailing Address - Phone:972-307-3920
Mailing Address - Fax:214-221-5600
Practice Address - Street 1:2919 S HAMPTON RD # F222
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-3026
Practice Address - Country:US
Practice Address - Phone:972-307-3920
Practice Address - Fax:214-221-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189349701Medicaid
TXDG9257OtherRAIL ROAD MEDICARE
TX189349701Medicaid
C49579Medicare UPIN