Healthcare Provider Details

I. General information

NPI: 1487673935
Provider Name (Legal Business Name): MATTHEW JOHN WINDROW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 AVENUE E
HONDO TX
78861
US

IV. Provider business mailing address

PO BOX 858
HONDO TX
78861-0858
US

V. Phone/Fax

Practice location:
  • Phone: 830-741-3054
  • Fax: 830-741-6290
Mailing address:
  • Phone: 830-741-3054
  • Fax: 830-741-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK3041
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: