MEDICARE: JOVIVE HEALTH - NEVADA KOURY & PARTNERS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician
3	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1336818574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOVIVE HEALTH - NEVADA KOURY & PARTNERS PC

Provider Business Mailing Address
First Line	:	2100 POWELL ST STE 400
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-1826
Country	:	US
Telephone Number	:	510-350-2842
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N PECOS RD STE 111
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-1995
Country	:	US
Telephone Number	:	702-263-4555
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THEOPHILE G. KOURY
Credential	:	MD
Telephone Number	:	510-350-2644

Provider Enumeration Date	:	09/10/2021
Last Update Date	:	04/04/2023

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