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General NPI Number Information
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NPI Number | 1992162606
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Entity Type | Organization
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Legal Business Name | TANNOURY MD PC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 2001 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89146-2990
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Country | US
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Telephone | 702-315-4600
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Fax | 702-315-4607
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Provider Business Mailing Address
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Address Line | 3144 BEACH VIEW CT
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City | LAS VEGAS
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State | NV
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Zip | 89117-3531
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Country | US
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Telephone | 702-510-5447
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Fax | 702-684-7469
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGES YOUSSEF TANNOURY
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Credential | MD
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Telephone | 702-510-5447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12311
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8820
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License Number State | NV
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