Basic Information
| Provider Information | |||||||||
| NPI: | 1114187747 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | BILAL | ||||||||
| MiddleName: | NAWAZ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6300 LA CALMA DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787523825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124528533 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 ELIZABETH ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784042235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618813000 | ||||||||
| FaxNumber: | 3618813149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2008 | ||||||||
| LastUpdateDate: | 08/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Q0775 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | Q0775 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | Q0775 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 70802 | 01 | AZ | ARIZONA LICENSE NUMBER | OTHER | Q0775 | 01 | TX | TEXAS LICENSE NUMBER | OTHER |