Organization
ADVANCED FAMILY MEDICAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHTARAM KHAN (OWNER)
(972) 985-8000
Entity
Organization
Contact information
Practice address
4002 W PARK BLVD, PLANO, TX 75093-3839
(972) 985-8000
Mailing address
PO BOX 262129, PLANO, TX 75026-2129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MDL1628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051HA
BLUE CROSS BLUE SHIELD
TX
05
—
157608401
—
TX
01
—
DB0572
MEDICARE B - RAIL ROAD
TX
Enumeration date
11/19/2007
Last updated
02/05/2013
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