Basic Information
| Provider Information | |||||||||
| NPI: | 1326466384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KHAWJA | ||||||||
| FirstName: | SHUMAILA | ||||||||
| MiddleName: | NOORUDDIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4310 JAMES CASEY ST STE 3C | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787451120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122440766 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Practice Location | |||||||||
| Address1: | 4310 JAMES CASEY ST STE 3C | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787451120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122440766 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2014 | ||||||||
| LastUpdateDate: | 08/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2019034145 | MO | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | T2903 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0102X | 2019034145 | MO | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | T2903 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.