Healthcare Provider Details

I. General information

NPI: 1285646471
Provider Name (Legal Business Name): MATTHEW HOGGATT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BLOSSOM ST SUITE 220
WEBSTER TX
77598
US

IV. Provider business mailing address

250 BLOSSOM ST STE 220
WEBSTER TX
77598-4243
US

V. Phone/Fax

Practice location:
  • Phone: 281-332-0202
  • Fax: 281-332-5266
Mailing address:
  • Phone: 281-332-0202
  • Fax: 281-332-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberM4163
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: