Provider Demographics
NPI:1902922230
Name:SCOUROS, MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:SCOUROS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANNA
Other - Last Name:SCOUROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1220 BLALOCK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6472
Mailing Address - Country:US
Mailing Address - Phone:713-464-3343
Mailing Address - Fax:713-464-2644
Practice Address - Street 1:1220 BLALOCK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6472
Practice Address - Country:US
Practice Address - Phone:713-464-3343
Practice Address - Fax:713-464-2644
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5741207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110021950OtherRAILROAD MEDICARE
TX114790201-02Medicaid
TX110021950OtherRAILROAD MEDICARE
TXB26290Medicare UPIN