MEDICARE: TEHMINA 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	207Q00000X	Family Medicine Physician	J9131	TX

General Provider Information

NPI Number	:	1922186014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEHMINA A. KHAN MD

Provider Business Mailing Address
First Line	:	PO BOX 616788
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32861-6788
Country	:	US
Telephone Number	:	407-447-7120
Fax Number	:	407-770-0661

Provider Business Practice Location Address
First Line	:	4435 W FUQUA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-6205
Country	:	US
Telephone Number	:	713-848-1910
Fax Number	:	833-749-0327

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/29/2021

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