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Provider Information for 1487712543



DR. BRUCE A MATSON D.D.S.

Gender: MALE

Individual NPI: 1487712543

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1487712543
Enumeration Date 2006-12-04
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8243 COLGATE ST
HOUSTON, TX 77061-1105
United States

Phone: 713-644-7711 | Fax: 713-644-6125
View Map External Link
Primary Practice Address 8243 COLGATE ST
HOUSTON, TX 77061-1105
United States

Phone: 713-644-7711 | Fax: 713-644-6125
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 16119