Healthcare Provider Details

I. General information

NPI: 1033648753
Provider Name (Legal Business Name): JOSHUA MATTHEWS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 L DON DODSON DR STE 100
BEDFORD TX
76021-1844
US

IV. Provider business mailing address

3500 CAMP BOWIE BLVD
FORT WORTH TX
76107-2644
US

V. Phone/Fax

Practice location:
  • Phone: 817-283-0967
  • Fax: 817-358-4566
Mailing address:
  • Phone: 817-584-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA17974
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: