Individual
MICHAEL KHADEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5550 RITTIMAN RD, SAN ANTONIO, TX 78218-4703
(210) 227-5466
(210) 599-1152
Mailing address
5550 RITTIMAN RD, SAN ANTONIO, TX 78218-4703
(210) 227-5466
(210) 599-1152
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
343800000X
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343800000X
—
TX
Enumeration date
04/16/2015
Last updated
04/16/2015
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