Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 34.012373 | OH |
NPI | 1003297607 |
---|---|
Provider Name | Matthew Uy |
First Address | Jbsa - Ft Sam Houston, TX 78234 |
Second Address | Fort Sam Houston, TX 78234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 05/06/2019 |