Shujaat a Khan M D P a

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

E5132 Issued in TX

Legal business name

SHUJAAT A KHAN M D P A

Practice address

800 8TH Ave
Ste 404
Fort Worth, TX 76104

Phone

(817) 335-6363

Fax

(817) 870-1222

NPI assigned

Nov 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shujaat A Khan, MD

Title

President

Phone

(817) 335-6363

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1417138157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE",
            "address_2": "STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-335-6363",
            "fax_number": "817-870-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE",
            "address_2": "STE 404",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-335-6363",
            "fax_number": "817-870-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUJAAT A KHAN M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHUJAAT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-335-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "E5132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86W281",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200N93T",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4119241",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latha Shrivatsa
• Cynthia I Shrode, LPC
• Miloni Shroff, M.D.
• Susan Moses Shropshire, M.D.
• Karine Shufford
• Karen Elisabeth Shults, LPC
• Raymond Patrick Shupak, DMD, MD
• Twila May Shuquist, AGACNP-BC
• Larissa Shurley, LCDC
• Rebekah Shutter, LPC

• Plastic and Reconstructive Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.