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General NPI Number Information
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NPI Number | 1255424859
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Entity Type | Organization
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Legal Business Name | JALIL A KHAN, MD, PA
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 502 NORTH VALLEY PARKWAY SUITE 1
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City | LEWISVILLE
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State | TX
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Zip | 75067-3437
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Country | US
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Telephone | 972-353-8616
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Fax | 972-353-5352
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Provider Business Mailing Address
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Address Line | 502 NORTH VALLEY PARKWAY SUITE 1
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City | LEWISVILLE
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State | TX
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Zip | 75067-3437
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Country | US
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Telephone | 972-353-8616
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Fax | 972-353-5352
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Authorized Official
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Title or Position | OWNER
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Name | JALIL AZIZ KHAN
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Credential | M. D.
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Telephone | 972-353-8616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L2732
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L7013
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J9128
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License Number State | TX
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