Individual
KENNETH L. MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1504 TAUB LOOP, HOUSTON, TX 77030-1608
(713) 873-8890
(713) 873-8898
Mailing address
2 GREENWAY PLZ, SUITE 910, HOUSTON, TX 77046-0297
(713) 798-1750
(713) 798-1144
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
D1724
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115298501
—
TX
Enumeration date
10/12/2006
Last updated
04/11/2011
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