Organization Active NPI

Matthew St. Laurent MD., PA.

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1679765853
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
J4536 Issued in TX
Legal business name
MATTHEW ST. LAURENT MD., PA.
Practice address
18220 Tomball Pkwy
Suite 300
Houston, TX 77070-4347
Phone
(281) 921-1890
Fax
(281) 921-1897
NPI assigned
Aug 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Authorized official

Name
Mr. Matthew J St. Laurent, MDNPI 1700858909
Title
President
Phone
(281) 921-1890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X J4536 TX Primary

Addresses

Primary practice location

18220 Tomball Pkwy
Suite 300
Houston, TX 77070-4347

Mailing address

18220 Tomball Pkwy
Suite 300
Houston, TX 77070-4347
Phone (281) 921-1890

Other identifiers 2

IdentifierTypeStateIssuer
166571301MedicaidTX
8S2410OtherTXBCBSTX PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050616000939 TX Part B Supplier - Clinic/Group Practice 5890739130 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

10425 Huffmeister Rd
Ste 230
Houston, TX 77065
Phone (281) 921-1890

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501459200000",
    "number": "1679765853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18220 TOMBALL PKWY",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704347",
            "telephone_number": "281-921-1890",
            "fax_number": "281-921-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18220 TOMBALL PKWY",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704347",
            "telephone_number": "281-921-1890",
            "fax_number": "281-921-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW ST. LAURENT MD., PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2017-07-31",
        "status": "A",
        "authorized_official_last_name": "ST. LAURENT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-921-1890",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "J4536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166571301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX PIN",
            "identifier": "8S2410",
            "state": "TX"
        }
    ],
    "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 Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.