Healthcare Provider Details

I. General information

NPI: 1912817248
Provider Name (Legal Business Name): MEMPHIS RESPIRATORY CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 KIRBY PWKY SUITE 110
MEMPHIS TN
38120
US

IV. Provider business mailing address

PO BOX 770988
MEMPHIS TN
38177-0988
US

V. Phone/Fax

Practice location:
  • Phone: 901-316-9888
  • Fax: 901-844-1439
Mailing address:
  • Phone: 901-316-9888
  • Fax: 901-844-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KHAWAJA M MUDDASSIR
Title or Position: OWNER
Credential: MD
Phone: 901-316-9888