Provider Demographics
NPI:1669882676
Name:PROPST, MATTHEW STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:STEPHEN
Last Name:PROPST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2803 EARL RUDDER FWY S
Mailing Address - Street 2:STE 103
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6099
Mailing Address - Country:US
Mailing Address - Phone:513-803-0262
Mailing Address - Fax:513-636-6374
Practice Address - Street 1:2800 WINSLOW AVE # 3100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1144
Practice Address - Country:US
Practice Address - Phone:513-636-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.0291242080S0010X
IN01078341A2080S0010X
KY504552080S0010X
TXR1441208000000X, 2080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine