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General NPI Number Information
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NPI Number | 1518209758
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Entity Type | Individual
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Provider Name | MAURICE IBRAHIM KHAYAT M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 550 POPE AVE
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City | FORT LEAVENWORTH
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State | KS
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Zip | 66027-2332
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Country | US
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Telephone |
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | T3315
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | T3315
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License Number State | TX
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