Vander Woude, Matthew T

Vander Woude, Matthew T is an individual health care provider with primary practice located at 3111 Mccann Rd , Longview TX 75605-7842. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Vander Woude, Matthew T can be contacted via phone (903) 753-1212.

Contact Information

Primary practice address
3111 Mccann Rd Longview TX 75605-7842
Phone: (903) 753-1212
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X S1942 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 934 Nevada

Profile Details

NPI number 1376546424
LBN Legal business name Vander Woude, Matthew T
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Oct 19th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376546424 NPPES
Nevada MEDICAID 201875024

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