Provider Demographics
NPI:1003441569
Name:NOOR, SOUKAINA (MD)
Entity Type:Individual
Prefix:
First Name:SOUKAINA
Middle Name:
Last Name:NOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOUKAINA
Other - Middle Name:
Other - Last Name:KOUTEIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:NEUROLOGY RESIDENCY, 3551 ROGER BROOKE DR.
Mailing Address - Street 2:
Mailing Address - City:JBSA FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-2203
Mailing Address - Fax:210-916-3833
Practice Address - Street 1:NEUROLOGY RESIDENCY, 3551 ROGER BROOKE DR.
Practice Address - Street 2:
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-2203
Practice Address - Fax:210-916-3833
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101274046208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program