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General NPI Number Information
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NPI Number | 1649431800
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Entity Type | Individual
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Provider Name | NAVEED A KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 1101 6TH AVE SECOND FLOOR
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City | FORT WORTH
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State | TX
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Zip | 76104-4306
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Country | US
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Telephone | 817-632-5803
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Fax | 817-336-1331
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Provider Business Mailing Address
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Address Line | 5213 S ALSTON AVE
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City | DURHAM
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State | NC
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Zip | 27713-4430
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Country | US
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Telephone | 919-684-8111
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116020628
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2012-01370
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License Number State | NC
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