1326084039 NPI number — DR. SAJID RAZA KHAN M.D.

Table of content: DR. SAJID RAZA KHAN M.D. (NPI 1326084039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326084039 NPI number — DR. SAJID RAZA KHAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN
Provider First Name:
SAJID
Provider Middle Name:
RAZA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326084039
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 24005
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66283-4005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-271-4142
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16100 SOUTH FWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-413-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  0432831 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: R3699 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200573860B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00635003 . This is a "RR MEDICARE GROUP CG8899" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 200573860A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41336014 . This is a "BCBS KCMO SMMC EMERGENCY PHYSICIANS GROUP 01674018" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41336024 . This is a "BCBS KC MO ER PHYSICIANS SOUTH PA BCBS KCMO GROUP 30492021" identifier . This identifiers is of the category "OTHER".




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