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General NPI Number Information
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NPI Number | 1205320702
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Entity Type | Individual
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Provider Name | NABEELA KHAN
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 12000 US HIGHWAY 380
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City | CROSSROADS
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State | TX
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Zip | 76227-2339
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Country | US
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Telephone | 940-365-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 2440 ROTHERHAM CIR
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City | MCKINNEY
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State | TX
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Zip | 75071-1370
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Country | US
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Telephone | 847-496-7182
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.031756
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36063
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License Number State | TX
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