Provider Demographics
NPI:1720097173
Name:KHALAF, TARIQ HANNA (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:HANNA
Last Name:KHALAF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8320 LOUETTA RD STE 198
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6777
Mailing Address - Country:US
Mailing Address - Phone:713-654-1000
Mailing Address - Fax:281-826-0042
Practice Address - Street 1:8320 LOUETTA RD STE 198
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6777
Practice Address - Country:US
Practice Address - Phone:713-654-1000
Practice Address - Fax:281-826-0042
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2022-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF1703207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17838Medicare UPIN