Provider Demographics
NPI:1588663678
Name:ZYKORIE, STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:ZYKORIE
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:17070 RED OAK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2619
Practice Address - Country:US
Practice Address - Phone:281-444-7077
Practice Address - Fax:281-444-5799
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8742208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083556301Medicaid
TXP00998358OtherRAILROAD MEDICARE
TXB27860Medicare UPIN
TX083556301Medicaid
TX8L0637Medicare PIN