Provider Demographics
NPI:1356539910
Name:EL KHOURY, RAYMONDA (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMONDA
Middle Name:
Last Name:EL KHOURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 W 45TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3014
Mailing Address - Country:US
Mailing Address - Phone:512-451-5800
Mailing Address - Fax:512-459-1399
Practice Address - Street 1:3000 N IH 35 STE 635
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1858
Practice Address - Country:US
Practice Address - Phone:512-320-1500
Practice Address - Fax:512-459-1399
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3508207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352163501Medicaid
SCQ0075SMedicaid
NC1356539910Medicaid
TX448284YR6YMedicare PIN
NCNC7949BMedicare PIN
NC1356539910Medicaid