MEDICARE: MATTHEW PARKER BRANCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MO620	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8W4542	OTHER	TX	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194798744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW PARKER BRANCH MD

Provider Business Mailing Address
First Line	:	2460 N IH 35 E
Second Line	:	SUITE 270, PROFESSIONAL PLAZA
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5266
Country	:	US
Telephone Number	:	469-800-9800
Fax Number	:	469-800-9810

Provider Business Practice Location Address
First Line	:	2460 N IH 35 E
Second Line	:	SUITE 270, PROFESSIONAL PLAZA
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5266
Country	:	US
Telephone Number	:	469-800-9800
Fax Number	:	469-800-9810

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	03/29/2022

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