MEDICARE: UROLOGY SPECIALISTS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician
2	208800000X	Urology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689753915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY SPECIALISTS PA

Provider Business Mailing Address
First Line	:	17070 RED OAK DR STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2615
Country	:	US
Telephone Number	:	281-444-7077
Fax Number	:	281-444-5799

Provider Business Practice Location Address
First Line	:	17070 RED OAK DR STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2615
Country	:	US
Telephone Number	:	281-444-7077
Fax Number	:	281-444-5799

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STUART ZYKORIE
Credential	:	M.D.
Telephone Number	:	281-444-7077

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	06/29/2011

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Directions to “UROLOGY SPECIALISTS PA ” Practice Location

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