Provider Demographics
NPI:1932170149
Name:KHAN, MOHAMMED S (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:S
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13325 HARGRAVE ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4313
Mailing Address - Country:US
Mailing Address - Phone:281-955-7863
Mailing Address - Fax:
Practice Address - Street 1:13325 HARGRAVE ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4313
Practice Address - Country:US
Practice Address - Phone:281-955-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0161207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A5282OtherBC BS OF TEXAS
TX8A5282OtherBC BS OF TEXAS
NJ097005RW8Medicare PIN
NJI47607Medicare UPIN
NJ097005Medicare PIN
TX8L22069Medicare PIN
NJ097005P7GMedicare PIN