Matthews, Mark Walker
Matthews, Mark Walker is an sole proprietor health care provider with primary practice located at 8017 Crazy Horse Ln , Fort Worth TX 76137-4161. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Matthews, Mark Walker can be contacted via phone (817) 577-5717.Contact Information
Primary practice address
8017 Crazy Horse Ln
Fort Worth TX 76137-4161
Phone: (817) 577-5717
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 31431 | Texas |
Profile Details
| NPI number | 1609090471 |
|---|---|
| LBN Legal business name | Matthews, Mark Walker |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 12th, 2007 |
| Last updated | Jul 27th, 2022 - about 2 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 | 1609090471 | NPPES |
| Texas | MEDICAID | 1031619 |
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