Provider Demographics
NPI:1598873705
Name:SPINN, MATTHEW P (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:P
Last Name:SPINN
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 1:915 GESSNER
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-461-1026
Mailing Address - Fax:716-461-4358
Practice Address - Street 1:915 GESSNER
Practice Address - Street 2:SUITE 850
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-461-1026
Practice Address - Fax:716-461-4358
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4560207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183203201Medicaid
TX8F6663OtherBCBSTX
TX8G8877Medicare PIN
TX183203201Medicaid