Provider Demographics
NPI:1699076281
Name:HOUSTON ID PHYSICIAN, P.A.
Entity type:Organization
Organization Name:HOUSTON ID PHYSICIAN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-410-1464
Mailing Address - Street 1:837 FM 1960 RD W
Mailing Address - Street 2:STE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3423
Mailing Address - Country:US
Mailing Address - Phone:281-674-7812
Mailing Address - Fax:
Practice Address - Street 1:837 FM 1960 RD W
Practice Address - Street 2:STE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3423
Practice Address - Country:US
Practice Address - Phone:281-674-7812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty