Healthcare Provider Details

I. General information

NPI: 1679028807
Provider Name (Legal Business Name): DANIEL C. MATHEWS, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 ROUND ROCK WEST DR SUITE E203
ROUND ROCK TX
78681-5052
US

IV. Provider business mailing address

555 ROUND ROCK WEST DR SUITE E203
ROUND ROCK TX
78681-5052
US

V. Phone/Fax

Practice location:
  • Phone: 512-689-0386
  • Fax: 512-243-8965
Mailing address:
  • Phone: 512-689-0386
  • Fax: 512-243-8965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MATHEWS
Title or Position: PRESIDENT
Credential:
Phone: 512-454-5911