Provider Demographics
NPI:1346462660
Name:MATTEWAL, AMARBIR SINGH (MD)
Entity Type:Individual
Prefix:
First Name:AMARBIR
Middle Name:SINGH
Last Name:MATTEWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8307
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8307
Mailing Address - Country:US
Mailing Address - Phone:281-296-8788
Mailing Address - Fax:281-419-1921
Practice Address - Street 1:1111 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 250
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3476
Practice Address - Country:US
Practice Address - Phone:281-296-8788
Practice Address - Fax:281-419-1291
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083636207R00000X
TXN0255207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283714801Medicaid
TX283714802Medicaid
TXTXB131055Medicare PIN
TXTXB131058Medicare PIN