Individual
AURELIO MATAMOROS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F6915
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044953001
—
TX
01
—
044953002
MEDICAID-CSHCN
TX
01
—
8A3874
BCBS
TX
01
—
Q00090146
RAILROAD MEDICARE
TX
Enumeration date
10/03/2006
Last updated
10/22/2021
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