Healthcare Provider Details

I. General information

NPI: 1669459988
Provider Name (Legal Business Name): SAMMY E KHOURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 01/03/2017
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 STE 130
KATY TX
77494-0892
US

V. Phone/Fax

Practice location:
  • Phone: 281-347-0088
  • Fax: 281-347-0101
Mailing address:
  • Phone: 281-347-0088
  • Fax: 281-347-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: