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General NPI Number Information
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NPI Number | 1528491305
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Entity Type | Individual
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Provider Name | MATTHEW ALTMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 181 TOWN CENTER BLVD STE 400
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City | JARRELL
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State | TX
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Zip | 76537-4005
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Country | US
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Telephone | 512-746-2690
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 LANTANA RD
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City | BELTON
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State | TX
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Zip | 76513-7398
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Country | US
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Telephone | 832-656-4715
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10047430
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q7526
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License Number State | TX
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