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General NPI Number Information
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NPI Number | 1679765853
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Entity Type | Organization
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Legal Business Name | MATTHEW ST. LAURENT MD., PA.
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 07/31/2017
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Provider Practice Location Address
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Address Line | 18220 TOMBALL PKWY SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77070-4347
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Country | US
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Telephone | 281-921-1890
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Fax | 281-921-1897
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Provider Business Mailing Address
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Address Line | 18220 TOMBALL PKWY SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77070-4347
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Country | US
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Telephone | 281-921-1890
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Fax | 281-921-1897
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MATTHEW J ST. LAURENT
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Credential | MD
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Telephone | 281-921-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | J4536
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License Number State | TX
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