Organization Active NPI

Atique a. Khan M.D.P.a.

  • Psychiatry Physician
  • Denton, TX
National Provider Identifier
1861835787
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H7768 Issued in TX
Legal business name
ATIQUE A. KHAN M.D.P.A.
Practice address
2026 W University Dr
Denton, TX 76201-0644
Phone
(817) 488-5308
Fax
(817) 488-7149
NPI assigned
Apr 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Authorized official

Name
Atique A KhanNPI 1316044530
Title
Owner
Phone
(817) 488-5308

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X H7768 TX Primary

Addresses

Primary practice location

2026 W University Dr
Denton, TX 76201-0644

Mailing address

1023 Summerplace LN
Southlake, TX 76092-5121
Phone (817) 488-5308

Other identifiers 1

IdentifierTypeStateIssuer
114789402MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130507000330 TX Part B Supplier - Clinic/Group Practice 8325285505 Receives reassigned benefits from 1 practitioner
Practice locations: Carrollton, TX

National Provider Directory

National Provider Directory

Locations

2225 Parker Rd
Carrollton, TX 75010
Phone (972) 236-6800

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": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1861835787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 SUMMERPLACE LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925121",
            "telephone_number": "817-488-5308",
            "fax_number": "817-488-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 W UNIVERSITY DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762010644",
            "telephone_number": "817-488-5308",
            "fax_number": "817-488-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATIQUE A. KHAN M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ATIQUE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-488-5308"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H7768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114789402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.