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NPI Code Detail

MEDICARE: MATE-KOLE MEDICAL GROUP, LLC

MEDICARE: MATE-KOLE MEDICAL GROUP, LLC
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1659208189
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATE-KOLE MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 440 LOUISIANA ST STE 900
Second Line :
City : HOUSTON
State : TX
Zip : 77002-1062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 440 LOUISIANA ST STE 900
Second Line :
City : HOUSTON
State : TX
Zip : 77002-1062
Country : US
Telephone Number : 631-487-1806
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NENEYO MATE-KOLE
Credential :
Telephone Number : 631-487-1806
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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Directions to “MATE-KOLE MEDICAL GROUP, LLC ” Practice Location

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