Provider Demographics
NPI:1669459988
Name:KHOURY, SAMMY E (MD)
Entity Type:Individual
Prefix:
First Name:SAMMY
Middle Name:E
Last Name:KHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23960 KATY FWY
Mailing Address - Street 2:STE 130
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0892
Mailing Address - Country:US
Mailing Address - Phone:281-347-0088
Mailing Address - Fax:281-347-0102
Practice Address - Street 1:23960 KATY FWY
Practice Address - Street 2:SUITE 130
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1339
Practice Address - Country:US
Practice Address - Phone:281-347-0088
Practice Address - Fax:281-347-0101
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1827208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177202201Medicaid
TX177202201Medicaid
I42130Medicare UPIN