Provider Demographics
NPI:1811206105
Name:MATUK, JORGE ANTONIO (DPM)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ANTONIO
Last Name:MATUK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:6699 CHIMNEY ROCK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5339
Mailing Address - Country:US
Mailing Address - Phone:281-845-2039
Mailing Address - Fax:
Practice Address - Street 1:18220 TOMBALL PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:832-912-7792
Practice Address - Fax:832-912-7794
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT10-2010213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery