Provider Demographics
NPI:1619013950
Name:RED OAK UROLOGY CENTER PA
Entity Type:Organization
Organization Name:RED OAK UROLOGY CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:B
Authorized Official - Last Name:SKOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-437-6211
Mailing Address - Street 1:1140 CYPRESS STATION DRIVE
Mailing Address - Street 2:STE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090
Mailing Address - Country:US
Mailing Address - Phone:281-537-6211
Mailing Address - Fax:281-537-5999
Practice Address - Street 1:1140 CYPRESS STATION DRIVE
Practice Address - Street 2:STE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090
Practice Address - Country:US
Practice Address - Phone:281-537-6211
Practice Address - Fax:281-537-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00U13QMedicare ID - Type Unspecified