Healthcare Provider Details

I. General information

NPI: 1164818001
Provider Name (Legal Business Name): MATTHEW BUTLER REID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST SUITE 1700
HOUSTON TX
77030-1521
US

IV. Provider business mailing address

6767 LAKE WOODLANDS DR STE F
THE WOODLANDS TX
77382-2566
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-7500
  • Fax: 713-512-7240
Mailing address:
  • Phone: 281-364-1122
  • Fax: 281-210-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberT1821
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: