=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114686995
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KHAN CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2021
-----------------------------------------------------
Last Update Date | 04/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1840 HURSTVIEW DR
-----------------------------------------------------
City | HURST
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76054-2902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-528-7398
-----------------------------------------------------
Fax | 214-617-1082
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1840 HURSTVIEW DR
-----------------------------------------------------
City | HURST
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76054-2902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-528-7398
-----------------------------------------------------
Fax | 214-617-1082
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ARIF KHAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 945-208-4044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------