Provider Demographics
NPI:1255811873
Name:KHALAF, SAWSAN S
Entity type:Individual
Prefix:
First Name:SAWSAN
Middle Name:S
Last Name:KHALAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18142 WALDEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-6019
Mailing Address - Country:US
Mailing Address - Phone:346-268-7979
Mailing Address - Fax:832-538-0763
Practice Address - Street 1:18142 WALDEN FOREST DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-6019
Practice Address - Country:US
Practice Address - Phone:346-268-7979
Practice Address - Fax:832-538-0763
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health