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General NPI Number Information
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NPI Number | 1558514737
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Entity Type | Organization
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Legal Business Name | HEART HEALTH CENTER OF NORTH TEXAS PA
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 1600 REPUBLIC PKWY STE 100
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City | MESQUITE
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State | TX
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Zip | 75150-6919
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Country | US
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Telephone | 972-270-7005
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 REPUBLIC PKWY STE 100
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City | MESQUITE
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State | TX
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Zip | 75150-6919
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Country | US
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Telephone | 972-270-7005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHAMMAD NASRULLAH KHAN
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Credential | MD
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Telephone | 972-270-7005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | J9129
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License Number State | TX
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