Provider Demographics
NPI:1114360450
Name:MATHESON, LARA SELTZ (MD)
Entity type:Individual
Prefix:DR
First Name:LARA
Middle Name:SELTZ
Last Name:MATHESON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6560 FANNIN ST STE 1440
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2713
Mailing Address - Country:US
Mailing Address - Phone:713-790-9779
Mailing Address - Fax:713-790-1328
Practice Address - Street 1:6560 FANNIN ST STE 1440
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2713
Practice Address - Country:US
Practice Address - Phone:713-790-9700
Practice Address - Fax:790-790-1328
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2020-12-08
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Provider Licenses
StateLicense IDTaxonomies
TXR6240208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology