Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | T1821 | TX |
NPI | 1164818001 |
---|---|
Provider Name | Dr. Matthew Butler Reid |
First Address | The Woodlands, TX 77382-2566 |
Second Address | Houston, TX 77030-1521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2015 |
Last Update Date | 06/07/2021 |