Healthcare Provider Details

I. General information

NPI: 1922270487
Provider Name (Legal Business Name): MUHAMMAD AYUB KHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ALMA DR STE 105
PLANO TX
75025-3483
US

IV. Provider business mailing address

7801 ALMA DR STE 105
PLANO TX
75025-3483
US

V. Phone/Fax

Practice location:
  • Phone: 214-714-7010
  • Fax: 214-291-5210
Mailing address:
  • Phone: 214-714-7010
  • Fax: 214-291-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number491217
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: