Active NPI
Shadia B Khoury, M.ED.LPC
- Counselor
- San Antonio, TX
National Provider Identifier
1376729970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 62156
- Practice address
- 105 Furr Dr
San Antonio, TX 78201-4412 - Phone
- (830) 734-6268
- Fax
- (210) 568-4259
- NPI assigned
- Jan 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 62156 | TX | Primary |
Addresses
Primary practice location
105 Furr Dr
San Antonio, TX 78201-4412
Mailing address
105 Furr Dr
San Antonio, TX 78201-4412
Phone (830) 734-6268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 190427801 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62156 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1376729970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 FURR DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782014412",
"telephone_number": "830-734-6268",
"fax_number": "210-568-4259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 FURR DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782014412",
"telephone_number": "830-734-6268",
"fax_number": "210-568-4259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOURY",
"first_name": "SHADIA",
"middle_name": "B",
"credential": "M.ED.LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-14",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "62156",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "190427801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.