Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2019034145 | MO |
N | 208600000X | Surgeon | 2019034145 | MO |
Y | 208200000X | Surgeon | T2903 | TX |
Y | 208600000X | Surgeon | T2903 | TX |
N | 2086S0102X | Surgical Critical Care | 2019034145 | MO |
N | 2086S0102X | Surgical Critical Care | T2903 | TX |
NPI | 1326466384 |
---|---|
Provider Name | Dr. Shumaila Nooruddin Khawja |
First Address | Austin, TX 78745-1120 |
Second Address | Austin, TX 78745-1120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2014 |
Last Update Date | 12/08/2021 |