Provider Demographics
NPI:1700074572
Name:NABEEL A. KHAN, M.D.,P.A
Entity Type:Organization
Organization Name:NABEEL A. KHAN, M.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NABEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-291-8206
Mailing Address - Street 1:130 MEDICAL CENTER PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4943
Mailing Address - Country:US
Mailing Address - Phone:936-291-8205
Mailing Address - Fax:936-291-3862
Practice Address - Street 1:130 MEDICAL CENTER PKWY STE 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4943
Practice Address - Country:US
Practice Address - Phone:936-291-8205
Practice Address - Fax:936-291-3862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4019207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH46644Medicare UPIN