Healthcare Provider Details

I. General information

NPI: 1124407663
Provider Name (Legal Business Name): MATTHEW MAKOWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BLOSSOM ST
WEBSTER TX
77598-4204
US

IV. Provider business mailing address

301 UNIVERSITY BLVD MAIL ROUTE 1150
GALVESTON TX
77555-1150
US

V. Phone/Fax

Practice location:
  • Phone: 832-632-6500
  • Fax: 409-772-9532
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2019-00553
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2019-00553
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberU4561
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: