MEDICARE: HAMID ALI KHAN

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	183500000X	Pharmacist	33653	TX

General Provider Information

NPI Number	:	1427057827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAMID ALI KHAN

Provider Business Mailing Address
First Line	:	14322 DOUBLE SHOALS CIR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2478
Country	:	US
Telephone Number	:	832-693-1440
Fax Number	:	888-755-7380

Provider Business Practice Location Address
First Line	:	1615 N.MAIN
Second Line	:	CASA DE AMIGO HEALTH CENTER PHARMACY
City	:	HOUSTON
State	:	TX
Zip	:	77009
Country	:	US
Telephone Number	:	713-222-2272
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	11/05/2012

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Directions to “ HAMID ALI KHAN ” Practice Location

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