MEDICARE: SMART TESTING LABS & PHYSICIAN CARE PRACTICE PLLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1710749825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART TESTING LABS & PHYSICIAN CARE PRACTICE PLLC

Provider Business Mailing Address
First Line	:	12350 MONTWOOD DRIVE
Second Line	:	SUITE 300
City	:	EL PASO
State	:	TX
Zip	:	79928-5695
Country	:	US
Telephone Number	:	915-800-1115
Fax Number	:	915-800-1113

Provider Business Practice Location Address
First Line	:	12350 MONTWOOD DRIVE
Second Line	:	SUITE 300
City	:	EL PASO
State	:	TX
Zip	:	79928-5695
Country	:	US
Telephone Number	:	915-800-1115
Fax Number	:	915-800-1113

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MUHAMMAD KHAN
Credential	:
Telephone Number	:	630-703-8527

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	04/01/2025

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