Provider Demographics
NPI:1386130086
Name:TOZZI, MATHEUS
Entity type:Individual
Prefix:
First Name:MATHEUS
Middle Name:
Last Name:TOZZI
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 1:15167 WILLOW TREE LN
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-2569
Mailing Address - Country:US
Mailing Address - Phone:281-433-3696
Mailing Address - Fax:
Practice Address - Street 1:15167 WILLOW TREE LN
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-2569
Practice Address - Country:US
Practice Address - Phone:281-433-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX400714801Medicaid