Healthcare Provider Details

I. General information

NPI: 1225236391
Provider Name (Legal Business Name): SKS SURGICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23960 KATY FWY SUITE 130
KATY TX
77494-1339
US

IV. Provider business mailing address

23960 KATY FWY SUITE 130
KATY TX
77494-1339
US

V. Phone/Fax

Practice location:
  • Phone: 281-347-0088
  • Fax:
Mailing address:
  • Phone: 281-347-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM1827
License Number StateTX

VIII. Authorized Official

Name: DR. SAMMY E KHOURY
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 281-347-0088