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General NPI Number Information
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NPI Number | 1164514352
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Entity Type | Individual
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Provider Name | KASHIF ZAFAR KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 2301 N BRAZOSPORT BLVD
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City | FREEPORT
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State | TX
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Zip | 77541-3257
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Country | US
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Telephone | 979-238-5411
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Fax |
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Provider Business Mailing Address
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Address Line | 1606 COLERIDGE ST
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City | SUGAR LAND
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State | TX
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Zip | 77479-6697
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Country | US
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Telephone | 832-623-1716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 48476-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 22259
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 48476-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | M7328
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M7328
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22259
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License Number State | WV
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