MEDICARE: GHOLAM A KIANI KHOZANI M.D.

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	207V00000X	Obstetrics & Gynecology Physician	K6870	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00138HAB8K	OTHER	TX	PTAN
3	45D1006440	OTHER	TX	CLIA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	45D2237106	OTHER	TX	CLIA

General Provider Information

NPI Number	:	1558477513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GHOLAM A KIANI KHOZANI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 720206
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-0206
Country	:	US
Telephone Number	:	956-803-0401
Fax Number	:	956-322-5739

Provider Business Practice Location Address
First Line	:	5121 N JACKSON RD STE 10
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-6758
Country	:	US
Telephone Number	:	956-803-0401
Fax Number	:	956-322-5739

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	04/07/2026

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Directions to “ GHOLAM A KIANI KHOZANI M.D.” Practice Location

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