MEDICARE: HANI M SOROUR M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	TL 30337	SC

General Provider Information

NPI Number	:	1447446133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANI M SOROUR M.D.

Provider Business Mailing Address
First Line	:	3206 REVERE ST APT 117
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-2230
Country	:	US
Telephone Number	:	832-659-1429
Fax Number	:

Provider Business Practice Location Address
First Line	:	3206 REVERE ST APT 117
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-2230
Country	:	US
Telephone Number	:	832-659-1429
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	05/31/2024

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