| Organization Name: | SOUTHLAKE TROPHY CLUB RADIOLOGY |
| NPI Number: | 1568403046 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH KHAN (RADIOLOGIST) |
| Mailing Address: | 2800 South Highway 114 Trophy Club |
| State: | TX US |
| Postal Code: | 76726 |
| Phone Number: | 8179087810 |
| Fax Number: | 2063370544 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 11/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | L1091 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |