Healthcare Provider Details

I. General information

NPI: 1295463909
Provider Name (Legal Business Name): NEHAN ADIL KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 WESLEY ST
GREENVILLE TX
75401-5639
US

IV. Provider business mailing address

PO BOX 1908
GREENVILLE TX
75403-1908
US

V. Phone/Fax

Practice location:
  • Phone: 903-455-5958
  • Fax: 903-454-4514
Mailing address:
  • Phone: 903-455-5958
  • Fax: 903-454-4514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number50393
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberW0629
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: