Healthcare Provider Details

I. General information

NPI: 1326236712
Provider Name (Legal Business Name): KHALED AWAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KHALED ESMAEEL AWAD MD

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 JAMES CASEY ST STE C
AUSTIN TX
78745-1157
US

IV. Provider business mailing address

4316 JAMES CASEY ST STE C
AUSTIN TX
78745-1157
US

V. Phone/Fax

Practice location:
  • Phone: 512-807-3150
  • Fax:
Mailing address:
  • Phone: 512-807-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301084536
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberV2070
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2015028191
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberV2070
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD442730
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: