Individual
DR. KHOAN THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT211571
PA
2085B0100X
Body Imaging Physician
Primary
BP10077411
TX
2085R0202X
Diagnostic Radiology Physician
61779
CT
363A00000X
Physician Assistant
0110003559
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2010
Last updated
09/01/2021
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