Healthcare Provider Details

I. General information

NPI: 1497773121
Provider Name (Legal Business Name): NAZEER KHANANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 HERMANN DR
HOUSTON TX
77004-7005
US

IV. Provider business mailing address

PO BOX 650426
DALLAS TX
75265-0426
US

V. Phone/Fax

Practice location:
  • Phone: 713-527-5270
  • Fax: 713-527-5689
Mailing address:
  • Phone: 972-715-5007
  • Fax: 972-715-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberM3612
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: