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General NPI Number Information
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NPI Number | 1730536889
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Entity Type | Individual
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Provider Name | TAQUIUDDIN KHAJA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 200 S RIVERSHIRE DR STE 300
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City | CONROE
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State | TX
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Zip | 77304-3485
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Country | US
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Telephone | 936-777-8830
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Fax | 936-777-8831
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD MAIL STOP 2027
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-6050
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | T0535
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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 | 94-08942
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | T0535
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License Number State | TX
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