Provider Demographics
NPI:1730536889
Name:KHAJA, TAQUIUDDIN (DO)
Entity type:Individual
Prefix:
First Name:TAQUIUDDIN
Middle Name:
Last Name:KHAJA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MAIL STOP 2027
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6050
Mailing Address - Fax:
Practice Address - Street 1:200 S RIVERSHIRE DR STE 300
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3485
Practice Address - Country:US
Practice Address - Phone:936-777-8830
Practice Address - Fax:936-777-8831
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0535207R00000X, 207RN0300X
KS94-08942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine