Basic Information
| Provider Information | |||||||||
| NPI: | 1215677232 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHOLL | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | MARTIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22999 HIGHWAY 59 N STE 105 | ||||||||
| Address2: | |||||||||
| City: | KINGWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773394412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813488000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22999 HIGHWAY 59 N STE 105 | ||||||||
| Address2: | |||||||||
| City: | KINGWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773394412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813488000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2022 | ||||||||
| LastUpdateDate: | 03/30/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.