Physician Compare National (NPI:1790712784)

HEALTHCARE PROVIDER: MOHAMEDAOUF KHAZNADAR MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790712784
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0749343929
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090114000405
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHAZNADAR
	Individual professional last name
Provider First Name	MOHAMEDAOUF
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1901 MEDI PARK DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 124
	Group Practice or individual's line 2 address
City	AMARILLO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	791062106
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8063599866
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450209
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHWEST TEXAS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450231
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST ST ANTHONY'S HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y