Healthcare Provider Details

I. General information

NPI: 1831346394
Provider Name (Legal Business Name): NAAZ F. KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAAZ F. WAHEED MD

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 E SOUTHCROSS BLVD
SAN ANTONIO TX
78222-3723
US

IV. Provider business mailing address

PO BOX 708760
SANDY UT
84070-8760
US

V. Phone/Fax

Practice location:
  • Phone: 410-297-3010
  • Fax: 210-297-0352
Mailing address:
  • Phone: 801-352-9500
  • Fax: 801-352-7976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN1509
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: