Provider Demographics
NPI:1154766723
Name:KHAN, FAIZA (DPM)
Entity type:Individual
Prefix:
First Name:FAIZA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 W VIRGINIA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-7864
Mailing Address - Country:US
Mailing Address - Phone:972-709-7556
Mailing Address - Fax:972-709-7611
Practice Address - Street 1:1740 W VIRGINIA ST STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-7864
Practice Address - Country:US
Practice Address - Phone:972-709-7556
Practice Address - Fax:972-709-7611
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2243213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1104338086OtherGROUP NPI NUMBER