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General NPI Number Information
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NPI Number | 1255721569
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Entity Type | Organization
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Legal Business Name | NAK TRICITIES FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 123 S RANCH HOUSE RD
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City | WILLOW PARK
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State | TX
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Zip | 76008-2649
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Country | US
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Telephone | 817-984-7120
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Fax | 817-984-7121
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Provider Business Mailing Address
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Address Line | 123 S. RANCH HOUSE RD
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City | WILLOW PARK
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State | TX
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Zip | 76008-2649
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Country | US
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Telephone | 817-984-7120
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Fax | 817-984-7121
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Authorized Official
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Title or Position | OWNER/PHYSCIAN
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Name | DR. NADEEM A KHAN
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Credential |
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Telephone | 817-984-7120
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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 |
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License Number State |
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