Healthcare Provider Details

I. General information

NPI: 1538348438
Provider Name (Legal Business Name): MUHAMMAD ALI KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7215 WYOMING SPGS BUILDING 2, SUITE 300A
ROUND ROCK TX
78681-4312
US

IV. Provider business mailing address

7215 WYOMING SPGS BUILDING 2, SUITE 300A
ROUND ROCK TX
78681-4312
US

V. Phone/Fax

Practice location:
  • Phone: 512-388-1190
  • Fax: 512-388-1174
Mailing address:
  • Phone: 512-388-1190
  • Fax: 512-388-1174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD.202164
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number57012824
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberP4191
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: