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Individual
MOHAMEDAOUF KHAZNADAR
Active
Individual
MOHAMEDAOUF KHAZNADAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1504
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045DV
BLUE CROSS
—
01
—
110190468
RAILROAD MEDICARE
—
01
—
116723101
FIRSTCARE
—
05
—
135305411
—
TX
05
—
135305412
—
TX
05
—
135305413
—
TX
05
—
135306406
—
TX
01
—
752836096
TAX ID #
—
Enumeration date
06/27/2006
Last updated
02/11/2010
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