Provider Demographics
NPI:1174526990
Name:RIVER OAKS ENDOSCOPY LLP
Entity type:Organization
Organization Name:RIVER OAKS ENDOSCOPY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-494-3636
Mailing Address - Street 1:1501 RIVER POINTE DR
Mailing Address - Street 2:# 260
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2656
Mailing Address - Country:US
Mailing Address - Phone:936-494-3636
Mailing Address - Fax:936-494-3635
Practice Address - Street 1:1501 RIVER POINTE DR
Practice Address - Street 2:# 260
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2656
Practice Address - Country:US
Practice Address - Phone:936-494-3636
Practice Address - Fax:936-494-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007979261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH008AOtherBLUE CROSS PROVIDER #
TXHH008AOtherBLUE CROSS PROVIDER #
TXASC186Medicare PIN