Provider Demographics
NPI:1295705077
Name:KHAN, MUHAMMAD B (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:B
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1256
Mailing Address - Street 2:
Mailing Address - City:PEARSALL
Mailing Address - State:TX
Mailing Address - Zip Code:78061-1256
Mailing Address - Country:US
Mailing Address - Phone:830-334-3351
Mailing Address - Fax:830-334-3365
Practice Address - Street 1:421 S OAK ST
Practice Address - Street 2:
Practice Address - City:PEARSALL
Practice Address - State:TX
Practice Address - Zip Code:78061-3119
Practice Address - Country:US
Practice Address - Phone:830-334-3351
Practice Address - Fax:830-334-3365
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1357207P00000X, 207R00000X
VA0101251054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH29828Medicare UPIN