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General NPI Number Information
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NPI Number | 1144226036
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Entity Type | Individual
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Provider Name | FREDERICK L MATTHEWS DPM
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5072 W PLANO PKWY STE 220
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City | PLANO
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State | TX
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Zip | 75093-4475
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Country | US
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Telephone | 469-671-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 OLD SHEPARD PL STE 260
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City | PLANO
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State | TX
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Zip | 75093-5250
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Country | US
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Telephone | 314-741-3546
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Fax | 314-741-3548
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N006070-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016.005325
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2005012314
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2186
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License Number State | TX
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