# DR. KHOAN THAI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104130541
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MT211571 | PA | — |
| 2085B0100X | Body Imaging Physician | BP10077411 | TX | Yes |
| 2085R0202X | Diagnostic Radiology Physician | 61779 | CT | — |
| 363A00000X | Physician Assistant | 0110003559 | VA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 09/01/2021