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General NPI Number Information
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NPI Number | 1538306675
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Entity Type | Individual
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Provider Name | MATTHEW STEPHEN DENNISON MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 7490 BROMPTON ST APT#293
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City | HOUSTON
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State | TX
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Zip | 77025-2269
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Country | US
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Telephone | 281-827-1438
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Fax |
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Provider Business Mailing Address
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Address Line | 7490 BROMPTON ST APT#293
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City | HOUSTON
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State | TX
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Zip | 77025-2269
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Country | US
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Telephone | 281-827-1438
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | P0194
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License Number State | TX
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