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NPI Code Detail

MEDICARE: KHAKWANI MEDICAL CORPORATION, PC

MEDICARE: KHAKWANI MEDICAL CORPORATION, PC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1235851510
Entity Type Code : Organization
Provider Name (Legal Business Name) : KHAKWANI MEDICAL CORPORATION, PC
Provider Business Mailing Address
First Line : PO BOX 660048
Second Line :
City : DALLAS
State : TX
Zip : 75266-2901
Country : US
Telephone Number : 702-820-5713
Fax Number : 702-820-5713
Provider Business Practice Location Address
First Line : 6525 N DECATUR BLVD STE 150B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2993
Country : US
Telephone Number : 702-979-5903
Fax Number : 702-984-7315
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : VALERIE DENISE ESTRADA
Credential :
Telephone Number : 469-718-2768
Provider Enumeration Date : 09/14/2022
Last Update Date : 03/26/2025

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Directions to “KHAKWANI MEDICAL CORPORATION, PC ” Practice Location

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