Provider Demographics
NPI:1255721569
Name:NAK TRICITIES FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:NAK TRICITIES FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NADEEM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-984-7120
Mailing Address - Street 1:123 S. RANCH HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76008-2649
Mailing Address - Country:US
Mailing Address - Phone:817-984-7120
Mailing Address - Fax:817-984-7121
Practice Address - Street 1:123 S RANCH HOUSE RD
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76008-2649
Practice Address - Country:US
Practice Address - Phone:817-984-7120
Practice Address - Fax:817-984-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty