Provider Demographics
NPI:1154578243
Name:KHAN, AYESHA SULTANA (MD)
Entity type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:SULTANA
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AYESHA
Other - Middle Name:SULTANA
Other - Last Name:ZAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10455 N CENTRAL EXPY STE 110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2211
Mailing Address - Country:US
Mailing Address - Phone:469-527-5824
Mailing Address - Fax:
Practice Address - Street 1:10455 N CENTRAL EXPY STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2211
Practice Address - Country:US
Practice Address - Phone:469-527-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5995772-1205207Q00000X
UT5995772-8905207Q00000X
TXP4067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine