Individual
DR. MATTHEW ALEXANDER STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6431 FANNIN ST # 2.112, HOUSTON, TX 77030-1501
(713) 500-6765
(713) 500-5495
Mailing address
6431 FANNIN ST # 2.112, HOUSTON, TX 77030-1501
(713) 500-6765
(713) 500-5495
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
BP10082502
TX
390200000X
Student in an Organized Health Care Education/Training Program
11020118A
IN
Other
Enumeration date
05/31/2018
Last updated
05/19/2024
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