Healthcare Provider Details

I. General information

NPI: 1134418700
Provider Name (Legal Business Name): SAIQA IFTIKHAR KHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9230 KATY FWY STE 520
HOUSTON TX
77055-7467
US

IV. Provider business mailing address

9230 KATY FWY STE 520
HOUSTON TX
77055-7467
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-1061
  • Fax:
Mailing address:
  • Phone: 281-242-1061
  • Fax: 832-939-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number257717
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number257717
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberT2411
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: