Healthcare Provider Details

I. General information

NPI: 1508022740
Provider Name (Legal Business Name): MOHUMMED RADWAN KHANI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MOHUMMED RADWAN KHANI MD

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PROFESSIONAL PARK DR
WEBSTER TX
77598-4123
US

IV. Provider business mailing address

1407 BLAKELY GROVE LN
PEARLAND TX
77581-3553
US

V. Phone/Fax

Practice location:
  • Phone: 281-957-5655
  • Fax:
Mailing address:
  • Phone: 281-957-5655
  • Fax: 281-666-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberR0433
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR0433
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: