MEDICARE: DR. MOHAMMED S KHAN MD

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	207RC0000X	Cardiovascular Disease Physician	N0161	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8A5282	OTHER	TX	BC BS OF TEXAS

General Provider Information

NPI Number	:	1932170149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED S KHAN MD

Provider Business Mailing Address
First Line	:	13325 HARGRAVE ROAD
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77070-4313
Country	:	US
Telephone Number	:	281-955-7863
Fax Number	:

Provider Business Practice Location Address
First Line	:	13325 HARGRAVE ROAD
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77070-4313
Country	:	US
Telephone Number	:	281-955-7863
Fax Number	:

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	05/08/2018

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