Dyniewski, Justin Matthew

Dyniewski, Justin Matthew is an individual health care provider with primary practice located at 1527 Hemphill St , Fort Worth TX 76104-4706. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Dyniewski, Justin Matthew can be contacted via phone (817) 569-5900.

Contact Information

Primary practice address
1527 Hemphill St Fort Worth TX 76104-4706
Phone: (817) 569-5900
Fax: (817) 569-5998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X P2981 Texas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X P2981 Texas

Profile Details

NPI number 1588875827
LBN Legal business name Dyniewski, Justin Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Feb 5th, 2013 - about 12 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 1588875827 NPPES
Texas Other TXB160581 MEDICARE
Texas MEDICAID 306484201 MEDICARE
Texas Other P01103934 MEDICARE
Texas Other 306484202 MEDICARE
Texas Other 8DK337 MEDICARE

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