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General NPI Number Information
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NPI Number | 1437614641
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Entity Type | Individual
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Provider Name | MATTHEW CARTER APRN
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Gender | Male
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 3030 NORTH ST STE 460
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City | BEAUMONT
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State | TX
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Zip | 77702-1499
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Country | US
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Telephone | 409-892-6099
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 REBECCA LN
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City | BRIDGE CITY
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State | TX
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Zip | 77611-3127
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Country | US
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Telephone | 409-988-1599
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP140393
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License Number State | TX
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