Provider Demographics
NPI:1245717867
Name:ZAHN, MATTHEW ERVIN
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ERVIN
Last Name:ZAHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9380 W SAM HOUSTON PKWY S STE 80
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-5222
Mailing Address - Country:US
Mailing Address - Phone:832-300-2626
Mailing Address - Fax:
Practice Address - Street 1:9380 W SAM HOUSTON PKWY S STE 80
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-5222
Practice Address - Country:US
Practice Address - Phone:832-300-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2141056225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant