Active NPI
Matthew Vasquez, LAT
- Specialist
- The Woodlands, TX
National Provider Identifier
1750823134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AT5868
- Practice address
- 17450 St Lukes Way
Mac III, Suite 350
The Woodlands, TX 77384-8044 - Phone
- (936) 266-3130
- NPI assigned
- Nov 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AT5868 | TX | Primary |
Addresses
Primary practice location
17450 St Lukes Way
Mac III, Suite 350
The Woodlands, TX 77384-8044
Mailing address
17450 St Lukes Way
Mac III, Suite 350
The Woodlands, TX 77384-8044
Phone (936) 266-3130
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT5868 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479254400000",
"number": "1750823134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17450 ST LUKES WAY",
"address_2": "MAC III, SUITE 350",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773848044",
"telephone_number": "936-266-3130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17450 ST LUKES WAY",
"address_2": "MAC III, SUITE 350",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773848044",
"telephone_number": "936-266-3130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "MATTHEW",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-16",
"last_updated": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "AT5868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.