MEDICARE: DR. AMANDA L MATT PT

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	225100000X	Physical Therapist	1217288	TX

General Provider Information

NPI Number	:	1548523145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA L MATT PT

Provider Business Mailing Address
First Line	:	3711 GARTH RD STE 100
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77521-3176
Country	:	US
Telephone Number	:	281-420-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 GARTH RD STE 100
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77521-3176
Country	:	US
Telephone Number	:	281-420-3000
Fax Number	:

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

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	05/16/2022

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