Provider Demographics
NPI:1972579324
Name:KOEPPLINGER, MATTHEW E (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:E
Last Name:KOEPPLINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1521
Mailing Address - Country:US
Mailing Address - Phone:713-486-1890
Mailing Address - Fax:713-512-7240
Practice Address - Street 1:6400 FANNIN ST STE 1700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-486-1890
Practice Address - Fax:713-512-7240
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.008422207P00000X
TXN1370207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI32133Medicare UPIN
TXTXB104735Medicare PIN
TX8L15968Medicare PIN
TXP00876633Medicare PIN