MEDICARE: AMAL KHELA

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1922606185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAL KHELA

Provider Business Mailing Address
First Line	:	17014 BLUE MIST DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-1957
Country	:	US
Telephone Number	:	732-351-9234
Fax Number	:

Provider Business Practice Location Address
First Line	:	17014 BLUE MIST DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-1957
Country	:	US
Telephone Number	:	732-351-9234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2020
Last Update Date	:	10/10/2020

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Directions to “ AMAL KHELA ” Practice Location

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