1922363175 NPI number — DR. ASMA SHAHID KHAN MD

Table of content: MRS. SUMMER BROOKE COBURN-SCHEID PA (NPI 1336321041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922363175 NPI number — DR. ASMA SHAHID KHAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN
Provider First Name:
ASMA
Provider Middle Name:
SHAHID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHAHID
Provider Other First Name:
ASMA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922363175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
149 E SH 121
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
COPPELL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-833-7246
Provider Business Mailing Address Fax Number:
972-833-7256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 E SH 121
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
COPPELL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-833-7246
Provider Business Practice Location Address Fax Number:
972-833-7256
Provider Enumeration Date:
07/12/2012

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: 207Q00000X , with the licence number:  E-9276 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: R3887 , 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)