Healthcare Provider Details

I. General information

NPI: 1558757831
Provider Name (Legal Business Name): MAHJABEEN FATHIMA KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PROFESSIONAL PARK DR
WEBSTER TX
77598-4127
US

IV. Provider business mailing address

PO BOX 57845
WEBSTER TX
77598-7845
US

V. Phone/Fax

Practice location:
  • Phone: 281-332-3503
  • Fax: 281-332-3506
Mailing address:
  • Phone: 281-332-3503
  • Fax: 281-332-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS9010
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: