Healthcare Provider Details

I. General information

NPI: 1528108701
Provider Name (Legal Business Name): ERNEST L KHOURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CITY DALLAS
DALLAS TX
75230
US

IV. Provider business mailing address

PO BOX 670039
DALLAS TX
75367-0039
US

V. Phone/Fax

Practice location:
  • Phone: 214-378-9898
  • Fax: 214-378-9888
Mailing address:
  • Phone: 214-378-9898
  • Fax: 214-379-9888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMDE6117
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: