Southlake Trophy Club Radiology

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

L1091 Issued in TX

Legal business name

SOUTHLAKE TROPHY CLUB RADIOLOGY

Practice address

2800 South Highway 114
Trophy Club, TX 76726

Phone

(817) 908-7810

Fax

(206) 337-0544

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Khan, M.D.NPI 1629014386

Title

Radiologist

Phone

(817) 908-7810

Specialties & licenses 1

Addresses

Practitioners 1

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

• Sarah Khan, MD

  • Diagnostic Radiology Physician
  • Southlake, TX
  • NPI 1629014386
  NPD (past) Authorized official

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1568403046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 N PEARSON LN",
            "city": "WESTLAKE",
            "state": "TX",
            "postal_code": "762629016",
            "telephone_number": "817-908-7810",
            "fax_number": "206-337-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 SOUTH HIGHWAY 114",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76726",
            "telephone_number": "817-908-7810",
            "fax_number": "206-337-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE TROPHY CLUB RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "817-908-7810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L1091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Leann Seck, DPT
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• Cynthia Goodwin Smith, LCSW
• Justin Ray Smith, M.D.
• Andrew M Sohn, DMD, MD
• Spur Podiatry
• Sandy L Stetz, P.A.-C., M.ED.
• Christina Patchen Stuckey, DPT
• Charles Stump
• TCR Chiropractic PLLC

• Diagnostic Radiology Physician in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.