Provider Demographics
NPI:1801552344
Name:KHAN, SHAZAR HANIF (PMHNP)
Entity type:Individual
Prefix:
First Name:SHAZAR
Middle Name:HANIF
Last Name:KHAN
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11999 KATY FWY STE 156
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1627
Mailing Address - Country:US
Mailing Address - Phone:832-446-0872
Mailing Address - Fax:832-446-0787
Practice Address - Street 1:11999 KATY FWY STE 156
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1627
Practice Address - Country:US
Practice Address - Phone:832-446-0872
Practice Address - Fax:832-446-0787
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051094363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health