Provider Demographics
NPI:1992758668
Name:KHAN, HAFIZA HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:HAFIZA
Middle Name:HASSAN
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 PRESTON PARK BLVD STE 1450
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3691
Mailing Address - Country:US
Mailing Address - Phone:469-800-4540
Mailing Address - Fax:469-800-4541
Practice Address - Street 1:1820 PRESTON PARK BLVD
Practice Address - Street 2:SUITE 1450
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3691
Practice Address - Country:US
Practice Address - Phone:469-800-4540
Practice Address - Fax:469-800-4541
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2371207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P0980OtherBLUE CROSS BLUE SHIELD
TX151694002Medicaid
F86397Medicare UPIN
TX453834YKPTMedicare PIN