Provider Demographics
NPI:1255569307
Name:KHAN, ZESHAN MALIK (DO)
Entity type:Individual
Prefix:DR
First Name:ZESHAN
Middle Name:MALIK
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 SHANNON PL
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1514
Mailing Address - Country:US
Mailing Address - Phone:516-724-4449
Mailing Address - Fax:
Practice Address - Street 1:3901 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7738
Practice Address - Country:US
Practice Address - Phone:972-596-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2593931207L00000X
NJ25MB09283800207L00000X
TXR-2894207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology