Individual provider Active NPI

Rubina Fareed Khan, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1558328708
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J6523 Issued in TX
Practice address
6441 High Star Dr
Houston, TX 77074-5005
Phone
(832) 548-5000
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J6523 TX Primary

Addresses

Primary practice location

6441 High Star Dr
Houston, TX 77074-5005

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5000

Other identifiers 3

IdentifierTypeStateIssuer
079546001MedicaidTX
102747601MedicaidTX
018076201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170320001601 TX Practitioner - Pediatric Medicine 1456636133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6523TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc CurrentSince Feb 24, 2017 Accepting new patients
Legacy Community Health Services, Inc Pediatrics CurrentSince Feb 24, 2017 Accepting new patients

Locations

3430 Center St
Deer Park, TX 77536
Phone (832) 266-7303

5515 South Loop E
#B
Houston, TX 77033

5616 Lawndale St
Ste A108
Houston, TX 77023
Phone (713) 759-0912

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

6500 Rookin St
Ste 200
Houston, TX 77074
Phone (713) 351-7350

3021 Texas Pkwy
Missouri City, TX 77489

12540 Sugardale Dr
Stafford, TX 77477
Phone (601) 815-1368

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1558328708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6441 HIGH STAR DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770745005",
            "telephone_number": "832-548-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RUBINA",
        "middle_name": "FAREED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J6523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079546001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102747601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018076201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.