Provider Demographics
NPI:1992050017
Name:HOURY, MOHAMAD
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:HOURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 24TH RD S
Mailing Address - Street 2:APT 1231
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2635
Mailing Address - Country:US
Mailing Address - Phone:813-505-3735
Mailing Address - Fax:
Practice Address - Street 1:950 25TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2137
Practice Address - Country:US
Practice Address - Phone:813-505-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD043449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine