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General NPI Number Information
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NPI Number | 1861218463
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Entity Type | Organization
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Legal Business Name | MEDFUSE TEXAS PLLC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 8303 SOUTHWEST FWY STE 111
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City | HOUSTON
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State | TX
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Zip | 77074-1638
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Country | US
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Telephone | 346-738-9600
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Fax | 346-613-8400
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Provider Business Mailing Address
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Address Line | 4711 GOLF RD STE 900
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City | SKOKIE
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State | IL
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Zip | 60076-1247
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Country | US
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Telephone | 847-324-6800
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Fax | 224-251-7141
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MATTHEW DANIEL DUBE
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Credential | MD
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Telephone | 847-324-6800
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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