Provider Demographics
NPI:1730402967
Name:KHOURY, RENELIE SUBA (RT)
Entity type:Individual
Prefix:
First Name:RENELIE
Middle Name:SUBA
Last Name:KHOURY
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 777851
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-7851
Mailing Address - Country:US
Mailing Address - Phone:702-839-1114
Mailing Address - Fax:702-380-1081
Practice Address - Street 1:6070 S. FORT APACHE RD.
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-839-1114
Practice Address - Fax:702-380-1081
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC#1717227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified