Shabaz Khan, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SHABAZ KHAN, PLLC

Practice address

1650 W College St
Grapevine, TX 76051-3565

Phone

(817) 481-1588

NPI assigned

Jan 29, 2015

Organization subpart

No

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

Authorized official

Name

Shabaz Ali Khan, MD

Title

President

Phone

(817) 481-1588

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1710377791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 INDIAN PAINTBRUSH WAY",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926922",
            "telephone_number": "817-773-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W COLLEGE ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513565",
            "telephone_number": "817-481-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHABAZ KHAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHABAZ",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-481-1588",
        "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": []
}

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• Internal Medicine Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.