MEDICARE: S D KHAN MD PA

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	207RG0100X	Gastroenterology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255606885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S D KHAN MD PA

Provider Business Mailing Address
First Line	:	17070 RED OAK DR.
Second Line	:	SUITE 503
City	:	HOUSTON
State	:	TX
Zip	:	77090-2715
Country	:	US
Telephone Number	:	281-444-2399
Fax Number	:	281-444-3417

Provider Business Practice Location Address
First Line	:	17070 RED OAK DR.
Second Line	:	SUITE 503
City	:	HOUSTON
State	:	TX
Zip	:	77090-2715
Country	:	US
Telephone Number	:	281-444-2399
Fax Number	:	281-444-3417

Authorized Official
Title or Position	:	OFFICE ADMIN
Name	:	GRETCHEN DAULTON
Credential	:
Telephone Number	:	281-444-2399

Provider Enumeration Date	:	03/15/2012
Last Update Date	:	07/19/2023

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Directions to “S D KHAN MD PA ” Practice Location

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