Mir Mujtaba Ali Khan, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M3450 Issued in TX

Practice address

179 Interstate 45 S
Suite 300
Huntsville, TX 77340-4223

Phone

(936) 294-0152

Fax

(936) 294-9600

NPI assigned

Sep 25, 2006

Last updated

May 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mujtaba Ali-Khan Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ABHJAA

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

• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Internal Medicine

  Medicare reassignment NPD
• Hospital Docs PA

  • Internal Medicine Physician
  • Montgomery, TX
  • NPI 1871792309
  Medicare reassignment
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Burhani Surgical LTD PLLC

  dba Lone Star Surgical Solutions

  • Surgery Physician
  • Houston, TX
  • NPI 1811520737
  NPD (past)
• PCP for Life PA

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1497071955
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1831290923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 INTERSTATE 45 S",
            "address_2": "SUITE 300",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404223",
            "telephone_number": "936-294-0152",
            "fax_number": "936-294-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 INTERSTATE 45 S",
            "address_2": "SUITE 300",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404223",
            "telephone_number": "936-294-0152",
            "fax_number": "936-294-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI KHAN",
        "first_name": "MIR",
        "middle_name": "MUJTABA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MUJTABA",
            "last_name": "ALI-KHAN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Caitlyn Aizpiri
• Qussay Al Jawhar
• Sarah Dawn Alaway, DPT
• Asha Alexander
• Elizabeth Alexander
• Lisa Liang Alicea, MD
• Elizabeth Paige Latiolais Allen, MD
• Phillip L Allred, AUD
• Omar Akram Alnafoosi
• Victor Neftali Alvarado, LMT

• Internal Medicine Physician in Huntsville, TX
• Providers in Huntsville, 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 May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.