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General NPI Number Information
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NPI Number | 1922129774
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Entity Type | Individual
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Provider Name | ABDUL HAQ KHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 17183 INTERSTATE 45 S MEDICAL OFFICE BLDG-1, SUITE 640
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City | SHENANDOAH
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State | TX
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Zip | 77385-3312
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Country | US
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Telephone | 936-270-3880
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Fax | 936-270-3881
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Provider Business Mailing Address
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Address Line | 17183 INTERSTATE 45 S MEDICAL OFFICE BLDG 1; SUITE 640
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City | SHENANDOAH
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State | TX
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Zip | 77385-3312
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Country | US
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Telephone | 936-270-3880
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Fax | 936-270-3881
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 52028-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 45722
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | T3113
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License Number State | TX
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