Provider Demographics
NPI:1205823952
Name:SKOLNICK, ALAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WILLIAM
Last Name:SKOLNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 720
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-830-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8821208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034943304Medicaid
TX034943305Medicaid
TXP00695498OtherRAILROAD MEDICARE
TX034943303Medicaid
TX8BV064OtherBLUECROSS BLUESHIELD OF TX
TXTXB128627Medicare PIN
TX8L5022Medicare PIN
TX8BV064OtherBLUECROSS BLUESHIELD OF TX
TX8A6501Medicare ID - Type Unspecified