Individual provider Active NPI

Matthew Lemuel Nance, PH.D.

  • Clinical Neuropsychologist
  • Houston, TX
National Provider Identifier
1104867860
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2-4693 Issued in TX
Practice address
7515 Main St Ste 605
Houston, TX 77030-4515
Phone
(713) 796-9946
Fax
(713) 796-9873
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2-4693 TX Primary

Addresses

Primary practice location

7515 Main St Ste 605
Houston, TX 77030-4515

Mailing address

7515 Main St Ste 605
Houston, TX 77030-4515
Phone (713) 796-9946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2-4693TXMDClinical Neuropsychologist
4693TXMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1104867860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 MAIN ST STE 605",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304515",
            "telephone_number": "713-796-9946",
            "fax_number": "713-796-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 MAIN ST STE 605",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304515",
            "telephone_number": "713-796-9946",
            "fax_number": "713-796-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "MATTHEW",
        "middle_name": "LEMUEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "2-4693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.