Healthcare Provider Details

I. General information

NPI: 1932155884
Provider Name (Legal Business Name): JARI ULLAH KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CENTRAL EXPY N STE 235
ALLEN TX
75013-6135
US

IV. Provider business mailing address

1105 CENTRAL EXPY N STE 235
ALLEN TX
75013-6135
US

V. Phone/Fax

Practice location:
  • Phone: 972-747-6042
  • Fax: 972-747-6043
Mailing address:
  • Phone: 972-747-6042
  • Fax: 972-747-6043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12217700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberL9279
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL9279
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: