Provider Demographics
NPI:1205603123
Name:MATZ, LEANE RENEE (APRN)
Entity type:Individual
Prefix:MISS
First Name:LEANE
Middle Name:RENEE
Last Name:MATZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 GILLETTE ST APT 1080
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-2725
Mailing Address - Country:US
Mailing Address - Phone:281-844-8408
Mailing Address - Fax:
Practice Address - Street 1:919 GILLETTE ST APT 1080
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-2725
Practice Address - Country:US
Practice Address - Phone:281-844-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143496363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care