Provider Demographics
NPI:1174331664
Name:SK INNOVATIVE BRAIN HEALTH PLLC
Entity type:Organization
Organization Name:SK INNOVATIVE BRAIN HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAVEED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-381-4872
Mailing Address - Street 1:5570 FM 423 STE 110
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-8980
Mailing Address - Country:US
Mailing Address - Phone:217-381-4872
Mailing Address - Fax:
Practice Address - Street 1:8501 WADE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6262
Practice Address - Country:US
Practice Address - Phone:217-381-4872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty