MEDICARE: SUMBAL KHALID KHAN 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	207R00000X	Internal Medicine Physician	P5660	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	011856	OTHER	AL	MEDICARE GROUP NUMBER
2	1053406280	OTHER	AL	MEDICARE GROUP PAYEE NPI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851314421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMBAL KHALID KHAN M.D.

Provider Business Mailing Address
First Line	:	8911 N CAPITAL OF TEXAS HWY STE 1110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7203
Country	:	US
Telephone Number	:	877-279-5960
Fax Number	:	877-384-3106

Provider Business Practice Location Address
First Line	:	8911 N CAPITAL OF TEXAS HWY STE 1110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7203
Country	:	US
Telephone Number	:	877-279-5960
Fax Number	:	877-384-3106

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	04/18/2023

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Directions to “ SUMBAL KHALID KHAN M.D.” Practice Location

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