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General NPI Number Information
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NPI Number | 1710478714
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Entity Type | Organization
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Legal Business Name | PRESTIGE INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | 411 TRAVIS LN
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City | PROSPER
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State | TX
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Zip | 75078-8699
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Country | US
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Telephone | 516-404-4688
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Fax |
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Provider Business Mailing Address
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Address Line | 411 TRAVIS LN
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City | PROSPER
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State | TX
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Zip | 75078-8699
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Country | US
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Telephone | 516-404-4688
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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. HAROON S KHAN
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Credential | MD
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Telephone | 516-404-4688
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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 | P6657
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License Number State | TX
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