MEDICARE: MASROOR A 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	207RC0000X	Cardiovascular Disease Physician	K9583	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

General Provider Information

NPI Number	:	1861482861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASROOR A KHAN MD

Provider Business Mailing Address
First Line	:	PO BOX 540088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254-0088
Country	:	US
Telephone Number	:	713-850-1190
Fax Number	:	713-850-1327

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 2405
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2742
Country	:	US
Telephone Number	:	832-831-6932
Fax Number	:	832-831-6987

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	05/02/2018

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