MEDICARE: BRENDA R MATZKE

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	363L00000X	Nurse Practitioner	AP132673	TX
2	363LP2300X	Primary Care Nurse Practitioner	AP132673	TX

General Provider Information

NPI Number	:	1497290910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA R MATZKE

Provider Business Mailing Address
First Line	:	4700 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1058
Country	:	US
Telephone Number	:	832-445-4777
Fax Number	:	888-635-4503

Provider Business Practice Location Address
First Line	:	4700 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1058
Country	:	US
Telephone Number	:	832-445-4777
Fax Number	:	888-635-4503

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

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	05/06/2025

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Directions to “ BRENDA R MATZKE ” Practice Location

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