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NPI Code Detail

MEDICARE: DR. KHAWAJA NIMR IKRAM D.O.

MEDICARE: DR. KHAWAJA NIMR IKRAM D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianP0984TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P0984OTHERTXTEXAS LICENSE NUMBER

General Provider Information

NPI Number : 1174604474
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KHAWAJA NIMR IKRAM D.O.
Provider Business Mailing Address
First Line : 4090 MAPLESHADE LN STE 100
Second Line :
City : PLANO
State : TX
Zip : 75093-0025
Country : US
Telephone Number : 214-592-9955
Fax Number : 214-592-9935
Provider Business Practice Location Address
First Line : 5655 W SPRING CREEK PKWY STE 115
Second Line :
City : PLANO
State : TX
Zip : 75024-4175
Country : US
Telephone Number : 214-592-9955
Fax Number : 214-592-9935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 04/19/2024

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