Active NPI
Mansoor Khan, DC
- Chiropractor
- San Antonio, TX
National Provider Identifier
1114148053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 9079
- Practice address
- 4402 Vance Jackson Rd Ste 112
San Antonio, TX 78230-5333 - Phone
- (210) 921-0265
- Fax
- (210) 922-9679
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 9079 | TX | Primary |
Addresses
Primary practice location
4402 Vance Jackson Rd Ste 112
San Antonio, TX 78230-5333
Mailing address
5202 Texana Dr Apt 1438
San Antonio, TX 78249-3903
Phone (210) 921-0265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 9079 | TX | MD | Chiropractor |
Interoperability endpoints
- https://api.platform.athenahealth.com/16435/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114148053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5202 TEXANA DR APT 1438",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782493903",
"telephone_number": "210-921-0265",
"fax_number": "210-922-9679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4402 VANCE JACKSON RD STE 112",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782305333",
"telephone_number": "210-921-0265",
"fax_number": "210-922-9679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MANSOOR",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "DC 9079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.