Provider Demographics
NPI:1871881227
Name:KHATRI, NUDRAT RAFIQ (MD)
Entity type:Individual
Prefix:
First Name:NUDRAT
Middle Name:RAFIQ
Last Name:KHATRI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:205 E UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6814
Mailing Address - Country:US
Mailing Address - Phone:512-868-1124
Mailing Address - Fax:512-868-9894
Practice Address - Street 1:2423 WILLIAMS DR
Practice Address - Street 2:SUITE 113
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3200
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:512-864-2668
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2021-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-9151207QG0300X
TXR1062207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR1062OtherLICENSE