Provider Demographics
NPI:1336130749
Name:TOMPSON, MATTHEW LUTES (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LUTES
Last Name:TOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-3372
Mailing Address - Fax:713-797-0622
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-3372
Practice Address - Fax:713-797-0622
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2030207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144038002Medicaid
TX144038004Medicaid
TXP00284940OtherMEDICARE RAILROAD
TX8FX438OtherBLUE CROSS BLUE SHIELD
TX144038002Medicaid
TXP00284940OtherMEDICARE RAILROAD