Crookston, Matthew David

Crookston, Matthew David is an individual health care provider with primary practice located at 2103 Pleasant Valley Dr , League City TX 77573-4430. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Crookston, Matthew David can be contacted via phone (713) 894-7104.

Contact Information

Primary practice address
2103 Pleasant Valley Dr League City TX 77573-4430
Phone: (713) 894-7104
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5719TG Texas

Profile Details

NPI number 1083654701
LBN Legal business name Crookston, Matthew David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Feb 12th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083654701 NPPES
Texas MEDICAID 038639301
Texas Other 410046076
Texas Other 7070163

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