MEDICARE: SOUTHERN ENDOCRINOLOGY

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1942028394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN ENDOCRINOLOGY

Provider Business Mailing Address
First Line	:	7504 SAN JACINTO PL # 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3233
Country	:	US
Telephone Number	:	972-682-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	7504 SAN JACINTO PL # 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3233
Country	:	US
Telephone Number	:	972-682-5700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH AZIM KHAN
Credential	:	MD
Telephone Number	:	319-427-1790

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	05/04/2026

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Directions to “SOUTHERN ENDOCRINOLOGY ” Practice Location

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