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General NPI Number Information
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NPI Number | 1326480732
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Entity Type | Individual
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Provider Name | RYAN MATTHIESEN DO
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Gender | Male
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1301 S BONNIE BRAE ST
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City | DENTON
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State | TX
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Zip | 76207-2003
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Country | US
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Telephone | 817-735-0269
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Fax | 940-565-3650
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Provider Business Mailing Address
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Address Line | PO BOX 99335
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City | FORT WORTH
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State | TX
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Zip | 76199-0335
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Country | US
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Telephone | 817-735-0269
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Fax | 940-565-3650
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q3232
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License Number State | TX
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