Healthcare Provider Details

I. General information

NPI: 1548522105
Provider Name (Legal Business Name): MATTHEW JAMES KAUFFMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 PEEK RD STE 130
KATY TX
77449-6978
US

IV. Provider business mailing address

6845 PEEK RD STE 130
KATY TX
77449-6978
US

V. Phone/Fax

Practice location:
  • Phone: 281-697-5400
  • Fax: 281-915-3599
Mailing address:
  • Phone: 281-697-5400
  • Fax: 281-915-3599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2012017229
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7957
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7957TG
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2012017229
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: