Healthcare Provider Details

I. General information

NPI: 1265348221
Provider Name (Legal Business Name): THE DESIGNATED DOCTOR NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12414 ALDERBROOK DR STE 101
AUSTIN TX
78758-2482
US

IV. Provider business mailing address

12414 ALDERBROOK DR STE 101
AUSTIN TX
78758-2482
US

V. Phone/Fax

Practice location:
  • Phone: 833-333-9267
  • Fax: 833-333-9267
Mailing address:
  • Phone: 833-333-9267
  • Fax: 833-333-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW HAMM
Title or Position: CEO
Credential: MD
Phone: 833-333-9267