Organization Active NPI

Nabeel Khan, MD PA

  • Internal Medicine Physician
  • Huntsville, TX
National Provider Identifier
1457978538
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NABEEL KHAN, MD PA
Practice address
130 Medical Center Pkwy Ste 1
Huntsville, TX 77340-4943
Phone
(936) 291-8205
Fax
(936) 291-3862
NPI assigned
Jul 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Authorized official

Name
Nabeel Khan, MDNPI 1144218066
Title
Owner
Phone
(936) 291-8205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

130 Medical Center Pkwy Ste 1
Huntsville, TX 77340-4943

Mailing address

130 Medical Center Pkwy Ste 1
Huntsville, TX 77340-4943
Phone (936) 291-8205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200825000232 TX Part B Supplier - Clinic/Group Practice 6406273374 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1068989Nabeel Khan, MD PA130 Medical Center Pkwy Ste 1, Huntsville, TX 77340Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1457978538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MEDICAL CENTER PKWY STE 1",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404943",
            "telephone_number": "936-291-8205",
            "fax_number": "936-291-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MEDICAL CENTER PKWY STE 1",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404943",
            "telephone_number": "936-291-8205",
            "fax_number": "936-291-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NABEEL KHAN, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NABEEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-291-8205",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.