1346381365 NPI number — DR. MARYAM KHAWARI MD

Table of content: DR. MARYAM KHAWARI MD (NPI 1346381365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346381365 NPI number — DR. MARYAM KHAWARI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAWARI
Provider First Name:
MARYAM
Provider Middle Name:
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:
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:
1346381365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11569 S HIGHWAY 6
Provider Second Line Business Mailing Address:
PMB 197
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77498-4932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-652-5943
Provider Business Mailing Address Fax Number:
281-652-5944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1531 WESTBOROUGH DR STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77449-8206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-652-5943
Provider Business Practice Location Address Fax Number:
281-652-5944
Provider Enumeration Date:
02/11/2007

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: 207RR0500X , with the licence number:  S9724 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RR0500X , with the licence number: 47166 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1W7221 . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 47166 . This is a "KY STATE LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1346381365 . This is a "ALL COMERICIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 431614301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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