Healthcare Provider Details

I. General information

NPI: 1568251361
Provider Name (Legal Business Name): KHALED ABDULLAH OJJOH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 09/18/2026
Certification Date:
Deactivation Date: 02/19/2026
Reactivation Date: 09/18/2026

III. Provider practice location address

1100 ALLIED DR
PLANO TX
75093
US

IV. Provider business mailing address

1100 ALLIED DR
PLANO TX
75093
US

V. Phone/Fax

Practice location:
  • Phone: 469-452-3272
  • Fax:
Mailing address:
  • Phone: 469-452-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberBP10098700
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: