Provider Demographics
NPI:1730420894
Name:DO, KHANHLY T (PA - C)
Entity type:Individual
Prefix:MISS
First Name:KHANHLY
Middle Name:T
Last Name:DO
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2070
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1541
Mailing Address - Country:US
Mailing Address - Phone:713-486-8000
Mailing Address - Fax:713-486-8088
Practice Address - Street 1:1631 N LOOP WEST, STE 245
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-486-8150
Practice Address - Fax:713-486-8155
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08349363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical