Provider Demographics
NPI:1669449617
Name:DAR, KHAVAR J (MD)
Entity type:Individual
Prefix:DR
First Name:KHAVAR
Middle Name:J
Last Name:DAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 7179
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-7179
Mailing Address - Country:US
Mailing Address - Phone:432-332-5557
Mailing Address - Fax:432-332-5558
Practice Address - Street 1:420 E 6TH ST STE 201B
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4572
Practice Address - Country:US
Practice Address - Phone:432-332-5557
Practice Address - Fax:432-332-5558
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK9047207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG39470Medicare UPIN
TX8F7910Medicare Oscar/Certification