Individual
DR. KENNETH B MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6400 FANNIN ST STE 1700, HOUSTON, TX 77030-1526
(713) 486-5555
(713) 486-7533
Mailing address
6400 FANNIN ST STE 1700, HOUSTON, TX 77030-1526
(713) 486-5555
(713) 486-7533
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H0610
TX
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
H0610
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8S9717
BCBS
TX
Enumeration date
06/13/2006
Last updated
07/25/2022
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