Provider Demographics
NPI:1023491321
Name:RASHDAN, KHALID
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:RASHDAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SAINT JULIET ST APT 2212
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-1236
Mailing Address - Country:US
Mailing Address - Phone:817-583-2485
Mailing Address - Fax:
Practice Address - Street 1:3200 SAINT JULIET ST
Practice Address - Street 2:2212
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-1200
Practice Address - Country:US
Practice Address - Phone:817-583-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-04
Last Update Date:2015-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent