| Medical Care At Home Pa Dba Khan Medical Clinic | |
|
5077 E Interstate 20 Service Rd N Willow Park TX 76087-3219 | |
| (817) 374-4949 | |
| (817) 596-3700 |
| Full Name | Medical Care At Home Pa Dba Khan Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 5077 E Interstate 20 Service Rd N, Willow Park, Texas |
| Authorized Official Name and Position | Nusrat Ali Khan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8175975632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Care At Home Pa Dba Khan Medical Clinic Po Box 1313 Weatherford TX 76086-1313 Ph: (817) 374-4949 | Medical Care At Home Pa Dba Khan Medical Clinic 5077 E Interstate 20 Service Rd N Willow Park TX 76087-3219 Ph: (817) 374-4949 |
| NPI Number | 1154839652 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 01/16/2024 |
| Medicare PECOS PAC ID | 8426310038 |
|---|---|
| Medicare Enrollment ID | O20180320000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154839652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nusrat A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316053408 PECOS PAC ID: 6305872342 Enrollment ID: I20070627000389 |
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