Provider Demographics
NPI:1013933480
Name:KHOURY, FIRAS GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:GEORGE
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 1:1840 E RAY RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8720
Mailing Address - Country:US
Mailing Address - Phone:855-397-0197
Mailing Address - Fax:800-272-6512
Practice Address - Street 1:15895 SW 72ND AVE STE 250
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-7966
Practice Address - Country:US
Practice Address - Phone:503-624-5630
Practice Address - Fax:503-624-9149
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27000207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR134795OtherMEDICARE GROUP PIN
ORR134795OtherMEDICARE GROUP PIN
ORR134795OtherMEDICARE GROUP PIN
ORR135600Medicare PIN