Healthcare Provider Details

I. General information

NPI: 1821827353
Provider Name (Legal Business Name): MUHAMMAD HASSAAN KHALID
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST MSB 2.262
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

6431 FANNIN ST MSB 2.262
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5302
  • Fax: 713-500-0712
Mailing address:
  • Phone: 713-500-5302
  • Fax: 713-500-0712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberBP10088513
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: