Allred, Matt
Allred, Matt is an individual health care provider with primary practice located at 5002 Cowhorn Creek Rd , Texarkana TX 75503-9766. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Allred, Matt can be contacted via phone (903) 614-3000.Contact Information
Primary practice address
5002 Cowhorn Creek Rd
Texarkana TX 75503-9766
Phone: (903) 614-3000
Fax: (903) 614-3525
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 618851 | Texas |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP116751 | Texas |
Profile Details
NPI number | 1700064789 |
---|---|
LBN Legal business name | Allred, Matt |
Credentials | Family Nurse Practitioner (FNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 1st, 2008 |
Last updated | Apr 30th, 2021 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700064789 | NPPES |
Oklahoma | MEDICAID | 200882070A |
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