MEDICARE: OMAR MATUK-VILLAZON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	P4351	TX
2	208D00000X	General Practice Physician	P4351	TX

General Provider Information

NPI Number	:	1184938722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMAR MATUK-VILLAZON MD

Provider Business Mailing Address
First Line	:	211 E 7TH ST STE 700
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-3218
Country	:	US
Telephone Number	:	888-478-8432
Fax Number	:

Provider Business Practice Location Address
First Line	:	7838 LONG POINT RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-3621
Country	:	US
Telephone Number	:	888-478-8432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	01/14/2026

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