Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | P6660 | TX |
NPI | 1346456092 |
---|---|
Provider Name | Tariq Nawaz Khan |
First Address | Fort Worth, TX 76104-2191 |
Second Address | Fort Worth, TX 76104-2191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 05/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306325YMHU | MEDICARE PIN-DALLAS (01) | TX |
306325YQ27 | MEDICARE-PIN-(99) (01) | TX |
8DW619 | BLUE CROSS (01) | TX |