Provider Demographics
NPI:1831417807
Name:DAR, KHOLA H (MD)
Entity type:Individual
Prefix:DR
First Name:KHOLA
Middle Name:H
Last Name:DAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2709
Mailing Address - Country:US
Mailing Address - Phone:512-978-8400
Mailing Address - Fax:512-901-9785
Practice Address - Street 1:1705 E 11TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2709
Practice Address - Country:US
Practice Address - Phone:512-978-8400
Practice Address - Fax:512-901-9785
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116022242207Q00000X
TXP7095207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine