Provider Demographics
NPI:1659697886
Name:KHURRAM, SOBIA K (MD)
Entity Type:Individual
Prefix:
First Name:SOBIA
Middle Name:K
Last Name:KHURRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOBIA
Other - Middle Name:
Other - Last Name:HAROON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:405 BELVIDERE ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2137
Mailing Address - Country:US
Mailing Address - Phone:224-489-7555
Mailing Address - Fax:
Practice Address - Street 1:5001 N PIEDRAS ST
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY,
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-4210
Practice Address - Country:US
Practice Address - Phone:915-564-6159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2014-02242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry