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NPI Code Detail

MEDICARE: DR. JASON ALBERT KOURI M.D.

MEDICARE: DR. JASON ALBERT KOURI 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
1207QA0505XAdult Medicine PhysicianP3183TX
2207QA0505XAdult Medicine PhysicianA63589CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649276965
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON ALBERT KOURI M.D.
Provider Business Mailing Address
First Line : 903 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3421
Country : US
Telephone Number : 817-877-5353
Fax Number : 817-877-5357
Provider Business Practice Location Address
First Line : 903 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-3421
Country : US
Telephone Number : 817-877-5353
Fax Number : 817-877-5357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/30/2020

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