Provider Demographics
NPI:1528108701
Name:KHOURY, ERNEST L (MD)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:L
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:PO BOX 670039
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75367-0039
Mailing Address - Country:US
Mailing Address - Phone:214-378-9898
Mailing Address - Fax:214-379-9888
Practice Address - Street 1:MEDICAL CITY DALLAS
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:214-378-9898
Practice Address - Fax:214-378-9888
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDE6117207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8A9057Medicare PIN