MEDICARE: ZARTASH ZAFAR KHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	04-34306	KS
2	207RI0200X	Infectious Disease Physician	P6661	TX

General Provider Information

NPI Number	:	1396965935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZARTASH ZAFAR KHAN MD

Provider Business Mailing Address
First Line	:	2990 BLACKBURN ST
Second Line	:	STE 1102
City	:	DALLAS
State	:	TX
Zip	:	75204-3113
Country	:	US
Telephone Number	:	316-519-0625
Fax Number	:

Provider Business Practice Location Address
First Line	:	2990 BLACKBURN ST
Second Line	:	STE 1102
City	:	DALLAS
State	:	TX
Zip	:	75204-3113
Country	:	US
Telephone Number	:	316-519-0625
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	09/02/2016

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