MEDICARE: MOHAMMAD O. KHAN, M.D., P.A.

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
1	207RI0200X	Infectious Disease Physician	L0328	TX

General Provider Information

NPI Number	:	1225138753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAMMAD O. KHAN, M.D., P.A.

Provider Business Mailing Address
First Line	:	10924 GRANT RD
Second Line	:	BMB412
City	:	HOUSTON
State	:	TX
Zip	:	77070-4445
Country	:	US
Telephone Number	:	281-955-0012
Fax Number	:

Provider Business Practice Location Address
First Line	:	18955 MEMORIAL NORTH
Second Line	:	#300
City	:	HUMBLE
State	:	TX
Zip	:	77338-4347
Country	:	US
Telephone Number	:	281-955-0012
Fax Number	:	832-237-9871

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. MOHAMMAD O. KHAN
Credential	:	M.D.
Telephone Number	:	281-955-0012

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	08/22/2008

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