Provider Demographics
NPI:1427248426
Name:KHAN, WALEED (MD)
Entity type:Individual
Prefix:DR
First Name:WALEED
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 FOREST BEND DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6822
Mailing Address - Country:US
Mailing Address - Phone:810-262-1755
Mailing Address - Fax:
Practice Address - Street 1:2709 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1017
Practice Address - Country:US
Practice Address - Phone:469-999-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086441207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics